| National Provider Identifier [NPI]: | 1659349942 |
| Last Name Of The Provider | KOSACK |
| First Name Of The Provider | CAROLYN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 COTTAGE GROVE RD |
| Street Address 2 Of The Provider | COTTAGE GROVE CARDIOLOGY |
| City Of The Provider | BLOOMFIELD |
| Zip Code Of The Provider | 060023060 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 4481 |
| Number Of Medicare Beneficiaries | 1061 |
| Total Submitted Charge Amount | 1156451.54 |
| Total Medicare Allowed Amount | 423947.26 |
| Total Medicare Payment Amount | 318370.48 |
| Total Medicare Standardized Payment Amount | 304368.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 621 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 34322.26 |
| Total Drug Medicare AllowedAmount | 26008.14 |
| Total Drug Medicare PaymentAmount | 20390.17 |
| Total Drug Medicare Standardized Payment Amount | 20390.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3860 |
| Number Of Medicare Beneficiaries With Medical Services | 1061 |
| Total Medical Submitted Charge Amount | 1122129.28 |
| Total Medical Medicare Allowed Amount | 397939.12 |
| Total Medical Medicare Payment Amount | 297980.31 |
| Total Medical Medicare Standardized Payment Amount | 283978.37 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 385 |
| Number Of Beneficiaries Age Greater 84 | 221 |
| Number Of Female Beneficiaries | 648 |
| Number Of Male Beneficiaries | 413 |
| Number Of Non Hispanic White Beneficiaries | 809 |
| Number Of Black or African American Beneficiaries | 187 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 794 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 267 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4484 |