| National Provider Identifier [NPI]: | 1366453243 |
| Last Name Of The Provider | MINTELL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 144 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST HARTFORD |
| Zip Code Of The Provider | 061183239 |
| 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 | 144 |
| Number Of Services | 6351 |
| Number Of Medicare Beneficiaries | 425 |
| Total Submitted Charge Amount | 484177.03 |
| Total Medicare Allowed Amount | 272123.58 |
| Total Medicare Payment Amount | 212180.01 |
| Total Medicare Standardized Payment Amount | 200445.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 331 |
| Number Of Medicare Beneficiaries With Drug Services | 241 |
| Total Drug Submitted ChargeAmount | 17245.03 |
| Total Drug Medicare AllowedAmount | 15175.93 |
| Total Drug Medicare PaymentAmount | 14602.17 |
| Total Drug Medicare Standardized Payment Amount | 14602.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 6020 |
| Number Of Medicare Beneficiaries With Medical Services | 425 |
| Total Medical Submitted Charge Amount | 466932 |
| Total Medical Medicare Allowed Amount | 256947.65 |
| Total Medical Medicare Payment Amount | 197577.84 |
| Total Medical Medicare Standardized Payment Amount | 185843.15 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 388 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0557 |