| National Provider Identifier [NPI]: | 1396726139 |
| Last Name Of The Provider | EGGLIN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | RHODE ISLAND MEDICAL IMAGING |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 11180 |
| Number Of Medicare Beneficiaries | 3348 |
| Total Submitted Charge Amount | 584615 |
| Total Medicare Allowed Amount | 180379.26 |
| Total Medicare Payment Amount | 134867.41 |
| Total Medicare Standardized Payment Amount | 131792.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 5300 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 2915 |
| Total Drug Medicare AllowedAmount | 967.3 |
| Total Drug Medicare PaymentAmount | 758.25 |
| Total Drug Medicare Standardized Payment Amount | 758.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 5880 |
| Number Of Medicare Beneficiaries With Medical Services | 3348 |
| Total Medical Submitted Charge Amount | 581700 |
| Total Medical Medicare Allowed Amount | 179411.96 |
| Total Medical Medicare Payment Amount | 134109.16 |
| Total Medical Medicare Standardized Payment Amount | 131034.06 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 761 |
| Number Of Beneficiaries Age 65 to 74 | 1033 |
| Number Of Beneficiaries Age 75 to 84 | 882 |
| Number Of Beneficiaries Age Greater 84 | 672 |
| Number Of Female Beneficiaries | 1885 |
| Number Of Male Beneficiaries | 1463 |
| Number Of Non Hispanic White Beneficiaries | 2655 |
| Number Of Black or African American Beneficiaries | 225 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2081 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1267 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9046 |