| National Provider Identifier [NPI]: | 1841583994 |
| Last Name Of The Provider | ALFONSO |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MSN APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 DIVISION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DERBY |
| Zip Code Of The Provider | 064181326 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 4538 |
| Number Of Medicare Beneficiaries | 573 |
| Total Submitted Charge Amount | 515065.95 |
| Total Medicare Allowed Amount | 185989.1 |
| Total Medicare Payment Amount | 133627.59 |
| Total Medicare Standardized Payment Amount | 144947.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1741 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 26745 |
| Total Drug Medicare AllowedAmount | 15657.54 |
| Total Drug Medicare PaymentAmount | 12039.44 |
| Total Drug Medicare Standardized Payment Amount | 12039.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2797 |
| Number Of Medicare Beneficiaries With Medical Services | 573 |
| Total Medical Submitted Charge Amount | 488320.95 |
| Total Medical Medicare Allowed Amount | 170331.56 |
| Total Medical Medicare Payment Amount | 121588.15 |
| Total Medical Medicare Standardized Payment Amount | 132907.63 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 417 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 391 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 464 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6825 |