| National Provider Identifier [NPI]: | 1245214311 |
| Last Name Of The Provider | DEGIACOMO |
| First Name Of The Provider | TERESA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 LIBBEY PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WEYMOUTH |
| Zip Code Of The Provider | 021893129 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 9738 |
| Number Of Medicare Beneficiaries | 1580 |
| Total Submitted Charge Amount | 1228495 |
| Total Medicare Allowed Amount | 529408.93 |
| Total Medicare Payment Amount | 390210.55 |
| Total Medicare Standardized Payment Amount | 353017.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2248 |
| Total Drug Medicare AllowedAmount | 1537.71 |
| Total Drug Medicare PaymentAmount | 1205.54 |
| Total Drug Medicare Standardized Payment Amount | 1205.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 9704 |
| Number Of Medicare Beneficiaries With Medical Services | 1580 |
| Total Medical Submitted Charge Amount | 1226247 |
| Total Medical Medicare Allowed Amount | 527871.22 |
| Total Medical Medicare Payment Amount | 389005.01 |
| Total Medical Medicare Standardized Payment Amount | 351812.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 778 |
| Number Of Beneficiaries Age 75 to 84 | 515 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 1042 |
| Number Of Male Beneficiaries | 538 |
| Number Of Non Hispanic White Beneficiaries | 1551 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1540 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9574 |