| National Provider Identifier [NPI]: | 1134199490 |
| Last Name Of The Provider | GILMAN |
| First Name Of The Provider | MATTHEW |
| 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 | MASSACHUSETTS GENERAL HOSPITAL DEPT OF RADIOLOGY |
| Street Address 2 Of The Provider | 55 FRUIT STREET, FND 202 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 02114 |
| 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 | 19 |
| Number Of Services | 14994 |
| Number Of Medicare Beneficiaries | 2598 |
| Total Submitted Charge Amount | 528127 |
| Total Medicare Allowed Amount | 115703.16 |
| Total Medicare Payment Amount | 87583.58 |
| Total Medicare Standardized Payment Amount | 84367.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10963 |
| Number Of Medicare Beneficiaries With Drug Services | 129 |
| Total Drug Submitted ChargeAmount | 10963 |
| Total Drug Medicare AllowedAmount | 2119.39 |
| Total Drug Medicare PaymentAmount | 1661.54 |
| Total Drug Medicare Standardized Payment Amount | 1661.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 4031 |
| Number Of Medicare Beneficiaries With Medical Services | 2598 |
| Total Medical Submitted Charge Amount | 517164 |
| Total Medical Medicare Allowed Amount | 113583.77 |
| Total Medical Medicare Payment Amount | 85922.04 |
| Total Medical Medicare Standardized Payment Amount | 82705.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 405 |
| Number Of Beneficiaries Age 65 to 74 | 1021 |
| Number Of Beneficiaries Age 75 to 84 | 836 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 1181 |
| Number Of Male Beneficiaries | 1417 |
| Number Of Non Hispanic White Beneficiaries | 2338 |
| Number Of Black or African American Beneficiaries | 79 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1950 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 648 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3538 |