| National Provider Identifier [NPI]: | 1154383610 |
| Last Name Of The Provider | SOBELL |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1244 BOYLSTON ST |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CHESTNUT HILL |
| Zip Code Of The Provider | 024672116 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 5751 |
| Number Of Medicare Beneficiaries | 863 |
| Total Submitted Charge Amount | 539383 |
| Total Medicare Allowed Amount | 308474.72 |
| Total Medicare Payment Amount | 221251.8 |
| Total Medicare Standardized Payment Amount | 209534.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1259 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 101038 |
| Total Drug Medicare AllowedAmount | 80945.44 |
| Total Drug Medicare PaymentAmount | 63455.49 |
| Total Drug Medicare Standardized Payment Amount | 63455.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 4492 |
| Number Of Medicare Beneficiaries With Medical Services | 863 |
| Total Medical Submitted Charge Amount | 438345 |
| Total Medical Medicare Allowed Amount | 227529.28 |
| Total Medical Medicare Payment Amount | 157796.31 |
| Total Medical Medicare Standardized Payment Amount | 146079.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 520 |
| Number Of Beneficiaries Age 75 to 84 | 221 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 452 |
| Number Of Non Hispanic White Beneficiaries | 796 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 806 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8657 |