| National Provider Identifier [NPI]: | 1629052519 |
| Last Name Of The Provider | DEE |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 863 N MAIN STREET EXT |
| Street Address 2 Of The Provider | |
| City Of The Provider | WALLINGFORD |
| Zip Code Of The Provider | 064922434 |
| 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 | 204 |
| Number Of Services | 10559 |
| Number Of Medicare Beneficiaries | 2357 |
| Total Submitted Charge Amount | 574274.58 |
| Total Medicare Allowed Amount | 203952.84 |
| Total Medicare Payment Amount | 159975.17 |
| Total Medicare Standardized Payment Amount | 150813.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 6500 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 6500 |
| Total Drug Medicare AllowedAmount | 1239.96 |
| Total Drug Medicare PaymentAmount | 883.74 |
| Total Drug Medicare Standardized Payment Amount | 883.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 203 |
| Number Of Medical Services | 4059 |
| Number Of Medicare Beneficiaries With Medical Services | 2357 |
| Total Medical Submitted Charge Amount | 567774.58 |
| Total Medical Medicare Allowed Amount | 202712.88 |
| Total Medical Medicare Payment Amount | 159091.43 |
| Total Medical Medicare Standardized Payment Amount | 149930.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 372 |
| Number Of Beneficiaries Age 65 to 74 | 704 |
| Number Of Beneficiaries Age 75 to 84 | 720 |
| Number Of Beneficiaries Age Greater 84 | 561 |
| Number Of Female Beneficiaries | 1514 |
| Number Of Male Beneficiaries | 843 |
| Number Of Non Hispanic White Beneficiaries | 2044 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 180 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1463 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 894 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6445 |