| National Provider Identifier [NPI]: | 1700876125 |
| Last Name Of The Provider | DOUGHERTY |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 719 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 10404 |
| Number Of Medicare Beneficiaries | 3071 |
| Total Submitted Charge Amount | 960832.7 |
| Total Medicare Allowed Amount | 402240.7 |
| Total Medicare Payment Amount | 304140.8 |
| Total Medicare Standardized Payment Amount | 284133.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3571 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 23881.7 |
| Total Drug Medicare AllowedAmount | 13570.72 |
| Total Drug Medicare PaymentAmount | 10540.38 |
| Total Drug Medicare Standardized Payment Amount | 10540.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 6833 |
| Number Of Medicare Beneficiaries With Medical Services | 3071 |
| Total Medical Submitted Charge Amount | 936951 |
| Total Medical Medicare Allowed Amount | 388669.98 |
| Total Medical Medicare Payment Amount | 293600.42 |
| Total Medical Medicare Standardized Payment Amount | 273593.29 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 443 |
| Number Of Beneficiaries Age 65 to 74 | 953 |
| Number Of Beneficiaries Age 75 to 84 | 988 |
| Number Of Beneficiaries Age Greater 84 | 687 |
| Number Of Female Beneficiaries | 1505 |
| Number Of Male Beneficiaries | 1566 |
| Number Of Non Hispanic White Beneficiaries | 2526 |
| Number Of Black or African American Beneficiaries | 209 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 244 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2099 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 972 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0343 |