| National Provider Identifier [NPI]: | 1750371936 |
| Last Name Of The Provider | ROSENTHAL |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | YAW 6 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| 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 | 103 |
| Number Of Services | 3226 |
| Number Of Medicare Beneficiaries | 2010 |
| Total Submitted Charge Amount | 475628 |
| Total Medicare Allowed Amount | 88806.09 |
| Total Medicare Payment Amount | 65090.03 |
| Total Medicare Standardized Payment Amount | 61659.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 337 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 2273 |
| Total Drug Medicare AllowedAmount | 496.67 |
| Total Drug Medicare PaymentAmount | 389.4 |
| Total Drug Medicare Standardized Payment Amount | 389.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 2889 |
| Number Of Medicare Beneficiaries With Medical Services | 2010 |
| Total Medical Submitted Charge Amount | 473355 |
| Total Medical Medicare Allowed Amount | 88309.42 |
| Total Medical Medicare Payment Amount | 64700.63 |
| Total Medical Medicare Standardized Payment Amount | 61270.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 886 |
| Number Of Beneficiaries Age 75 to 84 | 594 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 1285 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 1771 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1598 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 412 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4109 |