| National Provider Identifier [NPI]: | 1447434428 |
| Last Name Of The Provider | EGAN |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 MAIN ST |
| Street Address 2 Of The Provider | 2ND FLOOR, SUITE A |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011991619 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 4502 |
| Number Of Medicare Beneficiaries | 2943 |
| Total Submitted Charge Amount | 337777 |
| Total Medicare Allowed Amount | 156724.86 |
| Total Medicare Payment Amount | 118386.36 |
| Total Medicare Standardized Payment Amount | 116013.23 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 907 |
| Number Of Beneficiaries Age 75 to 84 | 812 |
| Number Of Beneficiaries Age Greater 84 | 695 |
| Number Of Female Beneficiaries | 1633 |
| Number Of Male Beneficiaries | 1310 |
| Number Of Non Hispanic White Beneficiaries | 2515 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 222 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1825 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1118 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9056 |