| National Provider Identifier [NPI]: | 1780675751 |
| Last Name Of The Provider | MUDROCK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 536 FRANKLIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MELROSE |
| Zip Code Of The Provider | 021761741 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2387 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 274205 |
| Total Medicare Allowed Amount | 113285.57 |
| Total Medicare Payment Amount | 86357.32 |
| Total Medicare Standardized Payment Amount | 81730.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 220 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 24100 |
| Total Drug Medicare AllowedAmount | 13150.67 |
| Total Drug Medicare PaymentAmount | 12788.31 |
| Total Drug Medicare Standardized Payment Amount | 12788.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 2167 |
| Number Of Medicare Beneficiaries With Medical Services | 291 |
| Total Medical Submitted Charge Amount | 250105 |
| Total Medical Medicare Allowed Amount | 100134.9 |
| Total Medical Medicare Payment Amount | 73569.01 |
| Total Medical Medicare Standardized Payment Amount | 68942.17 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 137 |
| Number Of Non Hispanic White Beneficiaries | 273 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9464 |