| National Provider Identifier [NPI]: | 1508047572 |
| Last Name Of The Provider | FINTELMANN |
| First Name Of The Provider | FLORIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | MASSACHUSETTS GENERAL HOSPITAL, DEPT OF RADIOLOGY |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| 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 | 23 |
| Number Of Services | 8408 |
| Number Of Medicare Beneficiaries | 1388 |
| Total Submitted Charge Amount | 294801 |
| Total Medicare Allowed Amount | 62588.54 |
| Total Medicare Payment Amount | 48699.19 |
| Total Medicare Standardized Payment Amount | 46102.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 6664 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 6664 |
| Total Drug Medicare AllowedAmount | 1382.54 |
| Total Drug Medicare PaymentAmount | 1083.86 |
| Total Drug Medicare Standardized Payment Amount | 1083.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1744 |
| Number Of Medicare Beneficiaries With Medical Services | 1388 |
| Total Medical Submitted Charge Amount | 288137 |
| Total Medical Medicare Allowed Amount | 61206 |
| Total Medical Medicare Payment Amount | 47615.33 |
| Total Medical Medicare Standardized Payment Amount | 45018.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 577 |
| Number Of Beneficiaries Age 75 to 84 | 443 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 688 |
| Number Of Male Beneficiaries | 700 |
| Number Of Non Hispanic White Beneficiaries | 1244 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1085 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 303 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0124 |