| National Provider Identifier [NPI]: | 1104898782 |
| Last Name Of The Provider | SACKNOFF |
| First Name Of The Provider | RICHARD |
| 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 | 55 FRUIT ST |
| Street Address 2 Of The Provider | WHT 2, RADIOLOGICAL ASSOCIATES |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 7350 |
| Number Of Medicare Beneficiaries | 4159 |
| Total Submitted Charge Amount | 423015 |
| Total Medicare Allowed Amount | 111545.98 |
| Total Medicare Payment Amount | 83128.36 |
| Total Medicare Standardized Payment Amount | 80961.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1393 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 1393 |
| Total Drug Medicare AllowedAmount | 268.86 |
| Total Drug Medicare PaymentAmount | 210.77 |
| Total Drug Medicare Standardized Payment Amount | 210.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 5957 |
| Number Of Medicare Beneficiaries With Medical Services | 4159 |
| Total Medical Submitted Charge Amount | 421622 |
| Total Medical Medicare Allowed Amount | 111277.12 |
| Total Medical Medicare Payment Amount | 82917.59 |
| Total Medical Medicare Standardized Payment Amount | 80750.24 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 717 |
| Number Of Beneficiaries Age 65 to 74 | 1402 |
| Number Of Beneficiaries Age 75 to 84 | 1304 |
| Number Of Beneficiaries Age Greater 84 | 736 |
| Number Of Female Beneficiaries | 2054 |
| Number Of Male Beneficiaries | 2105 |
| Number Of Non Hispanic White Beneficiaries | 3661 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 80 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2967 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1192 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2029 |