| National Provider Identifier [NPI]: | 1356326441 |
| Last Name Of The Provider | WARNER |
| First Name Of The Provider | JON |
| 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 | 55 FRUIT STREET |
| Street Address 2 Of The Provider | YAWKEY 3G |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142696 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 848 |
| Number Of Medicare Beneficiaries | 478 |
| Total Submitted Charge Amount | 1319641.5 |
| Total Medicare Allowed Amount | 214495.34 |
| Total Medicare Payment Amount | 162383.09 |
| Total Medicare Standardized Payment Amount | 150695.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 264 |
| Total Drug Medicare AllowedAmount | 93.58 |
| Total Drug Medicare PaymentAmount | 66.21 |
| Total Drug Medicare Standardized Payment Amount | 66.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 796 |
| Number Of Medicare Beneficiaries With Medical Services | 478 |
| Total Medical Submitted Charge Amount | 1319377.5 |
| Total Medical Medicare Allowed Amount | 214401.76 |
| Total Medical Medicare Payment Amount | 162316.88 |
| Total Medical Medicare Standardized Payment Amount | 150629.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 432 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1413 |