| National Provider Identifier [NPI]: | 1699828566 |
| Last Name Of The Provider | MEDEIROS |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 159 UNION ST |
| Street Address 2 Of The Provider | DEPARTMENT OF CARDIOLOGY |
| City Of The Provider | MARLBOROUGH |
| Zip Code Of The Provider | 017521274 |
| 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 | 94 |
| Number Of Services | 3641 |
| Number Of Medicare Beneficiaries | 891 |
| Total Submitted Charge Amount | 726296 |
| Total Medicare Allowed Amount | 225068.48 |
| Total Medicare Payment Amount | 171193.88 |
| Total Medicare Standardized Payment Amount | 167832.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 23698 |
| Total Drug Medicare AllowedAmount | 7711.58 |
| Total Drug Medicare PaymentAmount | 6077.73 |
| Total Drug Medicare Standardized Payment Amount | 6077.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 3445 |
| Number Of Medicare Beneficiaries With Medical Services | 891 |
| Total Medical Submitted Charge Amount | 702598 |
| Total Medical Medicare Allowed Amount | 217356.9 |
| Total Medical Medicare Payment Amount | 165116.15 |
| Total Medical Medicare Standardized Payment Amount | 161754.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 257 |
| Number Of Beneficiaries Age 75 to 84 | 275 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 413 |
| Number Of Non Hispanic White Beneficiaries | 759 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 563 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9238 |