| National Provider Identifier [NPI]: | 1437142551 |
| Last Name Of The Provider | RANDOLPH |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1389 W MAIN ST |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 067083104 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 3030 |
| Number Of Medicare Beneficiaries | 145 |
| Total Submitted Charge Amount | 112938.5 |
| Total Medicare Allowed Amount | 75594.64 |
| Total Medicare Payment Amount | 56389.74 |
| Total Medicare Standardized Payment Amount | 57313.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2065.5 |
| Total Drug Medicare AllowedAmount | 1958.63 |
| Total Drug Medicare PaymentAmount | 1854.82 |
| Total Drug Medicare Standardized Payment Amount | 1854.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2938 |
| Number Of Medicare Beneficiaries With Medical Services | 145 |
| Total Medical Submitted Charge Amount | 110873 |
| Total Medical Medicare Allowed Amount | 73636.01 |
| Total Medical Medicare Payment Amount | 54534.92 |
| Total Medical Medicare Standardized Payment Amount | 55458.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 129 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 47 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1313 |