| National Provider Identifier [NPI]: | 1699749135 |
| Last Name Of The Provider | WASSERMAN |
| First Name Of The Provider | EVAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 148 EAST AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORWALK |
| Zip Code Of The Provider | 068515721 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 4930 |
| Number Of Medicare Beneficiaries | 2899 |
| Total Submitted Charge Amount | 651740 |
| Total Medicare Allowed Amount | 163863.68 |
| Total Medicare Payment Amount | 127129.08 |
| Total Medicare Standardized Payment Amount | 121899.02 |
| 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 | 158 |
| Number Of Medical Services | 4930 |
| Number Of Medicare Beneficiaries With Medical Services | 2899 |
| Total Medical Submitted Charge Amount | 651740 |
| Total Medical Medicare Allowed Amount | 163863.68 |
| Total Medical Medicare Payment Amount | 127129.08 |
| Total Medical Medicare Standardized Payment Amount | 121899.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 1074 |
| Number Of Beneficiaries Age 75 to 84 | 917 |
| Number Of Beneficiaries Age Greater 84 | 641 |
| Number Of Female Beneficiaries | 1968 |
| Number Of Male Beneficiaries | 931 |
| Number Of Non Hispanic White Beneficiaries | 2401 |
| Number Of Black or African American Beneficiaries | 230 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 165 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 704 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4317 |