| National Provider Identifier [NPI]: | 1205827250 |
| Last Name Of The Provider | BHAWAN |
| First Name Of The Provider | JAG |
| 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 | 725 ALBANY ST |
| Street Address 2 Of The Provider | SHAPIRO 8 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021182526 |
| 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 | 25 |
| Number Of Services | 4560 |
| Number Of Medicare Beneficiaries | 2752 |
| Total Submitted Charge Amount | 716511 |
| Total Medicare Allowed Amount | 296805.49 |
| Total Medicare Payment Amount | 227188.65 |
| Total Medicare Standardized Payment Amount | 166267.16 |
| 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 | 25 |
| Number Of Medical Services | 4560 |
| Number Of Medicare Beneficiaries With Medical Services | 2752 |
| Total Medical Submitted Charge Amount | 716511 |
| Total Medical Medicare Allowed Amount | 296805.49 |
| Total Medical Medicare Payment Amount | 227188.65 |
| Total Medical Medicare Standardized Payment Amount | 166267.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 174 |
| Number Of Beneficiaries Age 65 to 74 | 1033 |
| Number Of Beneficiaries Age 75 to 84 | 983 |
| Number Of Beneficiaries Age Greater 84 | 562 |
| Number Of Female Beneficiaries | 1369 |
| Number Of Male Beneficiaries | 1383 |
| Number Of Non Hispanic White Beneficiaries | 2597 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2464 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 288 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0986 |