| National Provider Identifier [NPI]: | 1588605133 |
| Last Name Of The Provider | GELLER |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 133 OLD ROAD TO 9 ACRE COR |
| Street Address 2 Of The Provider | EMERSON HOSPITAL, DEPT. OF PATHOLOGY |
| City Of The Provider | CONCORD |
| Zip Code Of The Provider | 017424159 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1754 |
| Number Of Medicare Beneficiaries | 673 |
| Total Submitted Charge Amount | 298105 |
| Total Medicare Allowed Amount | 66988.91 |
| Total Medicare Payment Amount | 51699.26 |
| Total Medicare Standardized Payment Amount | 37170.05 |
| 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 | 26 |
| Number Of Medical Services | 1754 |
| Number Of Medicare Beneficiaries With Medical Services | 673 |
| Total Medical Submitted Charge Amount | 298105 |
| Total Medical Medicare Allowed Amount | 66988.91 |
| Total Medical Medicare Payment Amount | 51699.26 |
| Total Medical Medicare Standardized Payment Amount | 37170.05 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 640 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 571 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0911 |