| National Provider Identifier [NPI]: | 1639126311 |
| Last Name Of The Provider | EWALD |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14 RESEARCH PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | N CHELMSFORD |
| Zip Code Of The Provider | 018632412 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 5396 |
| Number Of Medicare Beneficiaries | 2763 |
| Total Submitted Charge Amount | 1148835 |
| Total Medicare Allowed Amount | 292489.49 |
| Total Medicare Payment Amount | 212689.83 |
| Total Medicare Standardized Payment Amount | 201339.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 12228 |
| Total Drug Medicare AllowedAmount | 6899.89 |
| Total Drug Medicare PaymentAmount | 4906.98 |
| Total Drug Medicare Standardized Payment Amount | 4906.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 5260 |
| Number Of Medicare Beneficiaries With Medical Services | 2763 |
| Total Medical Submitted Charge Amount | 1136607 |
| Total Medical Medicare Allowed Amount | 285589.6 |
| Total Medical Medicare Payment Amount | 207782.85 |
| Total Medical Medicare Standardized Payment Amount | 196432.41 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 633 |
| Number Of Beneficiaries Age 65 to 74 | 933 |
| Number Of Beneficiaries Age 75 to 84 | 728 |
| Number Of Beneficiaries Age Greater 84 | 469 |
| Number Of Female Beneficiaries | 1492 |
| Number Of Male Beneficiaries | 1271 |
| Number Of Non Hispanic White Beneficiaries | 2286 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | 170 |
| Number Of Hispanic Beneficiaries | 233 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1129 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8342 |