| National Provider Identifier [NPI]: | 1518116250 |
| Last Name Of The Provider | BOGORAD |
| First Name Of The Provider | ILYA |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 83 HERRICK ST |
| Street Address 2 Of The Provider | SUITE 1001 |
| City Of The Provider | BEVERLY |
| Zip Code Of The Provider | 019152757 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1291 |
| Number Of Medicare Beneficiaries | 441 |
| Total Submitted Charge Amount | 366848 |
| Total Medicare Allowed Amount | 167297.53 |
| Total Medicare Payment Amount | 127922.45 |
| Total Medicare Standardized Payment Amount | 130291.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 422 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 2884 |
| Total Drug Medicare AllowedAmount | 2208.31 |
| Total Drug Medicare PaymentAmount | 1729.36 |
| Total Drug Medicare Standardized Payment Amount | 1729.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 869 |
| Number Of Medicare Beneficiaries With Medical Services | 441 |
| Total Medical Submitted Charge Amount | 363964 |
| Total Medical Medicare Allowed Amount | 165089.22 |
| Total Medical Medicare Payment Amount | 126193.09 |
| Total Medical Medicare Standardized Payment Amount | 128561.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 414 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 303 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 138 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 1.4085 |