| National Provider Identifier [NPI]: | 1811941032 |
| Last Name Of The Provider | BLACKMAN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 271 CAREW ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY, MERCY MEDICAL CENTER |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011042377 |
| 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 | 276 |
| Number Of Services | 5262 |
| Number Of Medicare Beneficiaries | 2951 |
| Total Submitted Charge Amount | 792792 |
| Total Medicare Allowed Amount | 233469.93 |
| Total Medicare Payment Amount | 181135.92 |
| Total Medicare Standardized Payment Amount | 180867.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 276 |
| Number Of Medical Services | 5262 |
| Number Of Medicare Beneficiaries With Medical Services | 2951 |
| Total Medical Submitted Charge Amount | 792792 |
| Total Medical Medicare Allowed Amount | 233469.93 |
| Total Medical Medicare Payment Amount | 181135.92 |
| Total Medical Medicare Standardized Payment Amount | 180867.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 729 |
| Number Of Beneficiaries Age 65 to 74 | 940 |
| Number Of Beneficiaries Age 75 to 84 | 740 |
| Number Of Beneficiaries Age Greater 84 | 542 |
| Number Of Female Beneficiaries | 1936 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 2183 |
| Number Of Black or African American Beneficiaries | 255 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 453 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1685 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1266 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5926 |