| National Provider Identifier [NPI]: | 1033119813 |
| Last Name Of The Provider | HEIAT |
| First Name Of The Provider | ASEFEH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D., M.P.H. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4 SAGAMORE COVE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRANFORD |
| Zip Code Of The Provider | 064055020 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1085 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 224850 |
| Total Medicare Allowed Amount | 118580.66 |
| Total Medicare Payment Amount | 90210.22 |
| Total Medicare Standardized Payment Amount | 86550.33 |
| 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 | 9 |
| Number Of Medical Services | 1085 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 224850 |
| Total Medical Medicare Allowed Amount | 118580.66 |
| Total Medical Medicare Payment Amount | 90210.22 |
| Total Medical Medicare Standardized Payment Amount | 86550.33 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 245 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 112 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.5587 |