| National Provider Identifier [NPI]: | 1053379404 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 49 LAKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENWICH |
| Zip Code Of The Provider | 068304501 |
| 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 | 195 |
| Number Of Services | 6580 |
| Number Of Medicare Beneficiaries | 3624 |
| Total Submitted Charge Amount | 311176.25 |
| Total Medicare Allowed Amount | 285596.35 |
| Total Medicare Payment Amount | 222006.68 |
| Total Medicare Standardized Payment Amount | 213379.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 47.1 |
| Total Drug Medicare AllowedAmount | 43.73 |
| Total Drug Medicare PaymentAmount | 34.23 |
| Total Drug Medicare Standardized Payment Amount | 34.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 6539 |
| Number Of Medicare Beneficiaries With Medical Services | 3624 |
| Total Medical Submitted Charge Amount | 311129.15 |
| Total Medical Medicare Allowed Amount | 285552.62 |
| Total Medical Medicare Payment Amount | 221972.45 |
| Total Medical Medicare Standardized Payment Amount | 213344.93 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 165 |
| Number Of Beneficiaries Age 65 to 74 | 1266 |
| Number Of Beneficiaries Age 75 to 84 | 1252 |
| Number Of Beneficiaries Age Greater 84 | 941 |
| Number Of Female Beneficiaries | 2278 |
| Number Of Male Beneficiaries | 1346 |
| Number Of Non Hispanic White Beneficiaries | 3259 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 149 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 68 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 481 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3852 |