| National Provider Identifier [NPI]: | 1477555787 |
| Last Name Of The Provider | D'AMATO |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 136 BERLIN RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | CROMWELL |
| Zip Code Of The Provider | 064162627 |
| 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 | 18 |
| Number Of Services | 1578 |
| Number Of Medicare Beneficiaries | 384 |
| Total Submitted Charge Amount | 150355 |
| Total Medicare Allowed Amount | 102209.75 |
| Total Medicare Payment Amount | 67029.15 |
| Total Medicare Standardized Payment Amount | 62239.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 180 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 7425 |
| Total Drug Medicare AllowedAmount | 3689.25 |
| Total Drug Medicare PaymentAmount | 3615.24 |
| Total Drug Medicare Standardized Payment Amount | 3615.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1398 |
| Number Of Medicare Beneficiaries With Medical Services | 384 |
| Total Medical Submitted Charge Amount | 142930 |
| Total Medical Medicare Allowed Amount | 98520.5 |
| Total Medical Medicare Payment Amount | 63413.91 |
| Total Medical Medicare Standardized Payment Amount | 58623.86 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 358 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 319 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9605 |