| National Provider Identifier [NPI]: | 1598707762 |
| Last Name Of The Provider | LASTOMIRSKY |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1261 POST RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | FAIRFIELD |
| Zip Code Of The Provider | 068246072 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1849 |
| Number Of Medicare Beneficiaries | 375 |
| Total Submitted Charge Amount | 248868 |
| Total Medicare Allowed Amount | 159047 |
| Total Medicare Payment Amount | 124152.26 |
| Total Medicare Standardized Payment Amount | 118720.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1790 |
| Total Drug Medicare AllowedAmount | 716.8 |
| Total Drug Medicare PaymentAmount | 695.48 |
| Total Drug Medicare Standardized Payment Amount | 695.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1809 |
| Number Of Medicare Beneficiaries With Medical Services | 375 |
| Total Medical Submitted Charge Amount | 247078 |
| Total Medical Medicare Allowed Amount | 158330.2 |
| Total Medical Medicare Payment Amount | 123456.78 |
| Total Medical Medicare Standardized Payment Amount | 118025.45 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 328 |
| Number Of Black or African American Beneficiaries | 33 |
| 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 | 309 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2636 |