National Provider Identifier [NPI]: |
1891701777 |
Last Name Of The Provider |
ZIMMERMAN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 FOUNDERS PLZ |
Street Address 2 Of The Provider |
STE. 400 |
City Of The Provider |
EAST HARTFORD |
Zip Code Of The Provider |
061083212 |
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 |
120 |
Number Of Services |
26133 |
Number Of Medicare Beneficiaries |
3104 |
Total Submitted Charge Amount |
2613667 |
Total Medicare Allowed Amount |
430273.85 |
Total Medicare Payment Amount |
327036.68 |
Total Medicare Standardized Payment Amount |
307800.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
21733 |
Number Of Medicare Beneficiaries With Drug Services |
278 |
Total Drug Submitted ChargeAmount |
92189 |
Total Drug Medicare AllowedAmount |
8305.95 |
Total Drug Medicare PaymentAmount |
6413.56 |
Total Drug Medicare Standardized Payment Amount |
6413.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
117 |
Number Of Medical Services |
4400 |
Number Of Medicare Beneficiaries With Medical Services |
3101 |
Total Medical Submitted Charge Amount |
2521478 |
Total Medical Medicare Allowed Amount |
421967.9 |
Total Medical Medicare Payment Amount |
320623.12 |
Total Medical Medicare Standardized Payment Amount |
301387.01 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
629 |
Number Of Beneficiaries Age 65 to 74 |
940 |
Number Of Beneficiaries Age 75 to 84 |
936 |
Number Of Beneficiaries Age Greater 84 |
599 |
Number Of Female Beneficiaries |
1813 |
Number Of Male Beneficiaries |
1291 |
Number Of Non Hispanic White Beneficiaries |
2605 |
Number Of Black or African American Beneficiaries |
138 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
286 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
47 |
Number Of Beneficiaries With Medicare Only Entitlement |
1990 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1114 |
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 |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.6637 |