| National Provider Identifier [NPI]: | 1942270269 |
| Last Name Of The Provider | ZACHARY |
| First Name Of The Provider | KIMON |
| Middle Initial Of The Provider | C |
| 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 | MASSACHUSETTS GENERAL HOSPITAL |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142622 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 895 |
| Number Of Medicare Beneficiaries | 194 |
| Total Submitted Charge Amount | 284245 |
| Total Medicare Allowed Amount | 88420.55 |
| Total Medicare Payment Amount | 66220.79 |
| Total Medicare Standardized Payment Amount | 63040.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 5102 |
| Total Drug Medicare AllowedAmount | 3231.43 |
| Total Drug Medicare PaymentAmount | 3162.02 |
| Total Drug Medicare Standardized Payment Amount | 3162.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 834 |
| Number Of Medicare Beneficiaries With Medical Services | 194 |
| Total Medical Submitted Charge Amount | 279143 |
| Total Medical Medicare Allowed Amount | 85189.12 |
| Total Medical Medicare Payment Amount | 63058.77 |
| Total Medical Medicare Standardized Payment Amount | 59878.55 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 152 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 94 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.4633 |