| National Provider Identifier [NPI]: | 1548255342 |
| Last Name Of The Provider | KVATERNIK |
| First Name Of The Provider | DAVOR |
| 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 | 25 MARSTON ST |
| Street Address 2 Of The Provider | SUITE 404 |
| City Of The Provider | LAWRENCE |
| Zip Code Of The Provider | 018412310 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 4939 |
| Number Of Medicare Beneficiaries | 1381 |
| Total Submitted Charge Amount | 1298112 |
| Total Medicare Allowed Amount | 396333.59 |
| Total Medicare Payment Amount | 296419.21 |
| Total Medicare Standardized Payment Amount | 290643.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 236 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 37385 |
| Total Drug Medicare AllowedAmount | 12447.01 |
| Total Drug Medicare PaymentAmount | 9758.45 |
| Total Drug Medicare Standardized Payment Amount | 9758.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 4703 |
| Number Of Medicare Beneficiaries With Medical Services | 1381 |
| Total Medical Submitted Charge Amount | 1260727 |
| Total Medical Medicare Allowed Amount | 383886.58 |
| Total Medical Medicare Payment Amount | 286660.76 |
| Total Medical Medicare Standardized Payment Amount | 280885.5 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 284 |
| Number Of Beneficiaries Age 65 to 74 | 413 |
| Number Of Beneficiaries Age 75 to 84 | 409 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 902 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 445 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 769 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 612 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7716 |