| National Provider Identifier [NPI]: | 1801817960 |
| Last Name Of The Provider | CAVANAGH |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 BIRNIE AVE |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071107 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 3601 |
| Number Of Medicare Beneficiaries | 448 |
| Total Submitted Charge Amount | 484554.32 |
| Total Medicare Allowed Amount | 90005.98 |
| Total Medicare Payment Amount | 67282.49 |
| Total Medicare Standardized Payment Amount | 71888.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2342 |
| Number Of Medicare Beneficiaries With Drug Services | 218 |
| Total Drug Submitted ChargeAmount | 59268.32 |
| Total Drug Medicare AllowedAmount | 21358.9 |
| Total Drug Medicare PaymentAmount | 16582.71 |
| Total Drug Medicare Standardized Payment Amount | 16582.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1259 |
| Number Of Medicare Beneficiaries With Medical Services | 448 |
| Total Medical Submitted Charge Amount | 425286 |
| Total Medical Medicare Allowed Amount | 68647.08 |
| Total Medical Medicare Payment Amount | 50699.78 |
| Total Medical Medicare Standardized Payment Amount | 55305.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 271 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 369 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 313 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0555 |