| National Provider Identifier [NPI]: | 1366489312 |
| Last Name Of The Provider | VAISMAN |
| First Name Of The Provider | JULIEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10 CENTENNIAL DRIVE EAST ENTRANCE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEABODY |
| Zip Code Of The Provider | 01960 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 5701 |
| Number Of Medicare Beneficiaries | 690 |
| Total Submitted Charge Amount | 2055685.52 |
| Total Medicare Allowed Amount | 276688.02 |
| Total Medicare Payment Amount | 210510.26 |
| Total Medicare Standardized Payment Amount | 200944.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2786 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 58195.12 |
| Total Drug Medicare AllowedAmount | 15976.51 |
| Total Drug Medicare PaymentAmount | 12520.43 |
| Total Drug Medicare Standardized Payment Amount | 12520.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2915 |
| Number Of Medicare Beneficiaries With Medical Services | 690 |
| Total Medical Submitted Charge Amount | 1997490.4 |
| Total Medical Medicare Allowed Amount | 260711.51 |
| Total Medical Medicare Payment Amount | 197989.83 |
| Total Medical Medicare Standardized Payment Amount | 188423.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 265 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 453 |
| Number Of Male Beneficiaries | 237 |
| Number Of Non Hispanic White Beneficiaries | 657 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 528 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3278 |