| National Provider Identifier [NPI]: | 1487860524 |
| Last Name Of The Provider | RIVERA |
| First Name Of The Provider | ANTHONY |
| 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 | 123 SUMMER ST |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016081216 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5483 |
| Number Of Medicare Beneficiaries | 389 |
| Total Submitted Charge Amount | 474152.85 |
| Total Medicare Allowed Amount | 172138.65 |
| Total Medicare Payment Amount | 127538.78 |
| Total Medicare Standardized Payment Amount | 123779.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3943 |
| Number Of Medicare Beneficiaries With Drug Services | 281 |
| Total Drug Submitted ChargeAmount | 14655.85 |
| Total Drug Medicare AllowedAmount | 8798.68 |
| Total Drug Medicare PaymentAmount | 6731.09 |
| Total Drug Medicare Standardized Payment Amount | 6731.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1540 |
| Number Of Medicare Beneficiaries With Medical Services | 389 |
| Total Medical Submitted Charge Amount | 459497 |
| Total Medical Medicare Allowed Amount | 163339.97 |
| Total Medical Medicare Payment Amount | 120807.69 |
| Total Medical Medicare Standardized Payment Amount | 117048.64 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 175 |
| Number Of Non Hispanic White Beneficiaries | 340 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2287 |