National Provider Identifier [NPI]: |
1972540474 |
Last Name Of The Provider |
RECZEK |
First Name Of The Provider |
JAKUB |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D.M.B.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 BROOKLINE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
022155400 |
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 |
144 |
Number Of Services |
5819 |
Number Of Medicare Beneficiaries |
3768 |
Total Submitted Charge Amount |
804749 |
Total Medicare Allowed Amount |
226566.16 |
Total Medicare Payment Amount |
164781.31 |
Total Medicare Standardized Payment Amount |
160897.13 |
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 |
144 |
Number Of Medical Services |
5819 |
Number Of Medicare Beneficiaries With Medical Services |
3768 |
Total Medical Submitted Charge Amount |
804749 |
Total Medical Medicare Allowed Amount |
226566.16 |
Total Medical Medicare Payment Amount |
164781.31 |
Total Medical Medicare Standardized Payment Amount |
160897.13 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
612 |
Number Of Beneficiaries Age 65 to 74 |
1253 |
Number Of Beneficiaries Age 75 to 84 |
1113 |
Number Of Beneficiaries Age Greater 84 |
790 |
Number Of Female Beneficiaries |
2506 |
Number Of Male Beneficiaries |
1262 |
Number Of Non Hispanic White Beneficiaries |
3528 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2641 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1127 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4619 |