| National Provider Identifier [NPI]: | 1679576185 |
| Last Name Of The Provider | HARRIST |
| First Name Of The Provider | TERENCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMBRIDGE |
| Zip Code Of The Provider | 021394853 |
| 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 | 13 |
| Number Of Services | 12360 |
| Number Of Medicare Beneficiaries | 6112 |
| Total Submitted Charge Amount | 2545287.6 |
| Total Medicare Allowed Amount | 932767.06 |
| Total Medicare Payment Amount | 713910.26 |
| Total Medicare Standardized Payment Amount | 520438.69 |
| 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 | 13 |
| Number Of Medical Services | 12360 |
| Number Of Medicare Beneficiaries With Medical Services | 6112 |
| Total Medical Submitted Charge Amount | 2545287.6 |
| Total Medical Medicare Allowed Amount | 932767.06 |
| Total Medical Medicare Payment Amount | 713910.26 |
| Total Medical Medicare Standardized Payment Amount | 520438.69 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 2613 |
| Number Of Beneficiaries Age 75 to 84 | 2131 |
| Number Of Beneficiaries Age Greater 84 | 1134 |
| Number Of Female Beneficiaries | 3045 |
| Number Of Male Beneficiaries | 3067 |
| Number Of Non Hispanic White Beneficiaries | 5916 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 104 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5801 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 311 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0485 |