| National Provider Identifier [NPI]: | 1083720932 |
| Last Name Of The Provider | GUALTIERI |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | MILFORD IMAGING/RADIOLOGY |
| Street Address 2 Of The Provider | 14 PROSPECT STREET |
| City Of The Provider | MILFORD |
| Zip Code Of The Provider | 01757 |
| 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 | 135 |
| Number Of Services | 6495 |
| Number Of Medicare Beneficiaries | 3369 |
| Total Submitted Charge Amount | 566753 |
| Total Medicare Allowed Amount | 155161.67 |
| Total Medicare Payment Amount | 121648.26 |
| Total Medicare Standardized Payment Amount | 121548.5 |
| 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 | 135 |
| Number Of Medical Services | 6495 |
| Number Of Medicare Beneficiaries With Medical Services | 3369 |
| Total Medical Submitted Charge Amount | 566753 |
| Total Medical Medicare Allowed Amount | 155161.67 |
| Total Medical Medicare Payment Amount | 121648.26 |
| Total Medical Medicare Standardized Payment Amount | 121548.5 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 500 |
| Number Of Beneficiaries Age 65 to 74 | 1365 |
| Number Of Beneficiaries Age 75 to 84 | 954 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 2411 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 3220 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2643 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 726 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3762 |