| National Provider Identifier [NPI]: | 1427280460 |
| Last Name Of The Provider | SOUZA |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 FRANCIS ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021156110 |
| 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 | 153 |
| Number Of Services | 3254 |
| Number Of Medicare Beneficiaries | 2124 |
| Total Submitted Charge Amount | 463362 |
| Total Medicare Allowed Amount | 124396.3 |
| Total Medicare Payment Amount | 91756.59 |
| Total Medicare Standardized Payment Amount | 86495.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 3254 |
| Number Of Medicare Beneficiaries With Medical Services | 2124 |
| Total Medical Submitted Charge Amount | 463362 |
| Total Medical Medicare Allowed Amount | 124396.3 |
| Total Medical Medicare Payment Amount | 91756.59 |
| Total Medical Medicare Standardized Payment Amount | 86495.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 762 |
| Number Of Beneficiaries Age 75 to 84 | 592 |
| Number Of Beneficiaries Age Greater 84 | 422 |
| Number Of Female Beneficiaries | 1329 |
| Number Of Male Beneficiaries | 795 |
| Number Of Non Hispanic White Beneficiaries | 1757 |
| Number Of Black or African American Beneficiaries | 156 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 140 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1536 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 588 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6025 |