| National Provider Identifier [NPI]: | 1730123076 |
| Last Name Of The Provider | ODER |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 585 LEBANON ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MELROSE |
| Zip Code Of The Provider | 021763225 |
| 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 | 136 |
| Number Of Services | 6218 |
| Number Of Medicare Beneficiaries | 3741 |
| Total Submitted Charge Amount | 498728 |
| Total Medicare Allowed Amount | 169980.97 |
| Total Medicare Payment Amount | 127241.36 |
| Total Medicare Standardized Payment Amount | 123423.08 |
| 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 | 136 |
| Number Of Medical Services | 6218 |
| Number Of Medicare Beneficiaries With Medical Services | 3741 |
| Total Medical Submitted Charge Amount | 498728 |
| Total Medical Medicare Allowed Amount | 169980.97 |
| Total Medical Medicare Payment Amount | 127241.36 |
| Total Medical Medicare Standardized Payment Amount | 123423.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 572 |
| Number Of Beneficiaries Age 65 to 74 | 1179 |
| Number Of Beneficiaries Age 75 to 84 | 1161 |
| Number Of Beneficiaries Age Greater 84 | 829 |
| Number Of Female Beneficiaries | 2487 |
| Number Of Male Beneficiaries | 1254 |
| Number Of Non Hispanic White Beneficiaries | 3514 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1102 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5136 |