| National Provider Identifier [NPI]: | 1164417994 |
| Last Name Of The Provider | SPITZ |
| First Name Of The Provider | DAMON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 125 PARKER HILL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROXBURY CROSSING |
| Zip Code Of The Provider | 021202847 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 6024 |
| Number Of Medicare Beneficiaries | 2020 |
| Total Submitted Charge Amount | 874102.03 |
| Total Medicare Allowed Amount | 168119.81 |
| Total Medicare Payment Amount | 127532.95 |
| Total Medicare Standardized Payment Amount | 116331.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2435 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 11951 |
| Total Drug Medicare AllowedAmount | 985.52 |
| Total Drug Medicare PaymentAmount | 772.65 |
| Total Drug Medicare Standardized Payment Amount | 772.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3589 |
| Number Of Medicare Beneficiaries With Medical Services | 2020 |
| Total Medical Submitted Charge Amount | 862151.03 |
| Total Medical Medicare Allowed Amount | 167134.29 |
| Total Medical Medicare Payment Amount | 126760.3 |
| Total Medical Medicare Standardized Payment Amount | 115559.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 1048 |
| Number Of Beneficiaries Age 75 to 84 | 609 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 1275 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 1867 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1781 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 239 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0805 |