| National Provider Identifier [NPI]: | 1285763169 |
| Last Name Of The Provider | BANSAL |
| First Name Of The Provider | ANU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | STE. 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| 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 | 112 |
| Number Of Services | 20687 |
| Number Of Medicare Beneficiaries | 2734 |
| Total Submitted Charge Amount | 2255039 |
| Total Medicare Allowed Amount | 365529.77 |
| Total Medicare Payment Amount | 278027.22 |
| Total Medicare Standardized Payment Amount | 261953.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 16876 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 73014 |
| Total Drug Medicare AllowedAmount | 7590.41 |
| Total Drug Medicare PaymentAmount | 5950.92 |
| Total Drug Medicare Standardized Payment Amount | 5950.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 3811 |
| Number Of Medicare Beneficiaries With Medical Services | 2733 |
| Total Medical Submitted Charge Amount | 2182025 |
| Total Medical Medicare Allowed Amount | 357939.36 |
| Total Medical Medicare Payment Amount | 272076.3 |
| Total Medical Medicare Standardized Payment Amount | 256002.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 841 |
| Number Of Beneficiaries Age 75 to 84 | 776 |
| Number Of Beneficiaries Age Greater 84 | 588 |
| Number Of Female Beneficiaries | 1604 |
| Number Of Male Beneficiaries | 1130 |
| Number Of Non Hispanic White Beneficiaries | 2333 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 216 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1747 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 987 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.6526 |