| National Provider Identifier [NPI]: | 1063516573 |
| Last Name Of The Provider | PAO |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEEDHAM |
| Zip Code Of The Provider | 024922690 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 2509 |
| Number Of Medicare Beneficiaries | 561 |
| Total Submitted Charge Amount | 408777 |
| Total Medicare Allowed Amount | 171584.07 |
| Total Medicare Payment Amount | 137954.68 |
| Total Medicare Standardized Payment Amount | 129530.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 411 |
| Number Of Medicare Beneficiaries With Drug Services | 273 |
| Total Drug Submitted ChargeAmount | 42103 |
| Total Drug Medicare AllowedAmount | 24886.44 |
| Total Drug Medicare PaymentAmount | 24360.47 |
| Total Drug Medicare Standardized Payment Amount | 24360.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2098 |
| Number Of Medicare Beneficiaries With Medical Services | 561 |
| Total Medical Submitted Charge Amount | 366674 |
| Total Medical Medicare Allowed Amount | 146697.63 |
| Total Medical Medicare Payment Amount | 113594.21 |
| Total Medical Medicare Standardized Payment Amount | 105170.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 245 |
| Number Of Non Hispanic White Beneficiaries | 515 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0346 |