| National Provider Identifier [NPI]: | 1831373513 |
| Last Name Of The Provider | LITMANOVICH |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 330 BROOKLINE AVE |
| Street Address 2 Of The Provider | BETH ISRAEL DEACONESS MEDICAL CENTER-RADIOLOGY |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 022155400 |
| 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 | 70 |
| Number Of Services | 4389 |
| Number Of Medicare Beneficiaries | 2952 |
| Total Submitted Charge Amount | 335245 |
| Total Medicare Allowed Amount | 104966.1 |
| Total Medicare Payment Amount | 77837.51 |
| Total Medicare Standardized Payment Amount | 78068.73 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 531 |
| Number Of Beneficiaries Age 65 to 74 | 1091 |
| Number Of Beneficiaries Age 75 to 84 | 852 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 1478 |
| Number Of Male Beneficiaries | 1474 |
| Number Of Non Hispanic White Beneficiaries | 2465 |
| Number Of Black or African American Beneficiaries | 225 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 80 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2027 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 925 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9975 |