| National Provider Identifier [NPI]: | 1235154626 |
| Last Name Of The Provider | MARLATT |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30 COMMERCE PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILFORD |
| Zip Code Of The Provider | 064603551 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 6899 |
| Number Of Medicare Beneficiaries | 2016 |
| Total Submitted Charge Amount | 812567 |
| Total Medicare Allowed Amount | 234073.19 |
| Total Medicare Payment Amount | 189551.9 |
| Total Medicare Standardized Payment Amount | 175967.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3041 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 6082 |
| Total Drug Medicare AllowedAmount | 654.08 |
| Total Drug Medicare PaymentAmount | 463.3 |
| Total Drug Medicare Standardized Payment Amount | 463.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 3858 |
| Number Of Medicare Beneficiaries With Medical Services | 2016 |
| Total Medical Submitted Charge Amount | 806485 |
| Total Medical Medicare Allowed Amount | 233419.11 |
| Total Medical Medicare Payment Amount | 189088.6 |
| Total Medical Medicare Standardized Payment Amount | 175504.54 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 726 |
| Number Of Beneficiaries Age 75 to 84 | 635 |
| Number Of Beneficiaries Age Greater 84 | 432 |
| Number Of Female Beneficiaries | 1399 |
| Number Of Male Beneficiaries | 617 |
| Number Of Non Hispanic White Beneficiaries | 1815 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 500 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3633 |