| National Provider Identifier [NPI]: | 1275517294 |
| Last Name Of The Provider | FEDERMAN |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 56 QUARRY ROAD |
| Street Address 2 Of The Provider | 56 QUARRY ROAD |
| City Of The Provider | TRUMBULL |
| Zip Code Of The Provider | 066111351 |
| 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 | 229 |
| Number Of Services | 17182 |
| Number Of Medicare Beneficiaries | 2166 |
| Total Submitted Charge Amount | 1127209 |
| Total Medicare Allowed Amount | 313230.01 |
| Total Medicare Payment Amount | 241360.72 |
| Total Medicare Standardized Payment Amount | 227885.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 13596 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 13811 |
| Total Drug Medicare AllowedAmount | 2726.23 |
| Total Drug Medicare PaymentAmount | 2126.04 |
| Total Drug Medicare Standardized Payment Amount | 2126.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 225 |
| Number Of Medical Services | 3586 |
| Number Of Medicare Beneficiaries With Medical Services | 2166 |
| Total Medical Submitted Charge Amount | 1113398 |
| Total Medical Medicare Allowed Amount | 310503.78 |
| Total Medical Medicare Payment Amount | 239234.68 |
| Total Medical Medicare Standardized Payment Amount | 225759.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 331 |
| Number Of Beneficiaries Age 65 to 74 | 716 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 419 |
| Number Of Female Beneficiaries | 1263 |
| Number Of Male Beneficiaries | 903 |
| Number Of Non Hispanic White Beneficiaries | 1585 |
| Number Of Black or African American Beneficiaries | 286 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 240 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1437 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 729 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8197 |