| National Provider Identifier [NPI]: | 1184646747 |
| Last Name Of The Provider | MOTTA |
| First Name Of The Provider | MARIO |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 331 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 019701738 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 6401 |
| Number Of Medicare Beneficiaries | 2475 |
| Total Submitted Charge Amount | 1217173.81 |
| Total Medicare Allowed Amount | 358346 |
| Total Medicare Payment Amount | 273436.46 |
| Total Medicare Standardized Payment Amount | 263673.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 210 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 18272 |
| Total Drug Medicare AllowedAmount | 9795.12 |
| Total Drug Medicare PaymentAmount | 7679.39 |
| Total Drug Medicare Standardized Payment Amount | 7679.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 6191 |
| Number Of Medicare Beneficiaries With Medical Services | 2475 |
| Total Medical Submitted Charge Amount | 1198901.81 |
| Total Medical Medicare Allowed Amount | 348550.88 |
| Total Medical Medicare Payment Amount | 265757.07 |
| Total Medical Medicare Standardized Payment Amount | 255994.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 344 |
| Number Of Beneficiaries Age 65 to 74 | 706 |
| Number Of Beneficiaries Age 75 to 84 | 773 |
| Number Of Beneficiaries Age Greater 84 | 652 |
| Number Of Female Beneficiaries | 1318 |
| Number Of Male Beneficiaries | 1157 |
| Number Of Non Hispanic White Beneficiaries | 2229 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 130 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1767 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 708 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8905 |