| National Provider Identifier [NPI]: | 1952322711 |
| Last Name Of The Provider | GOTTFRIED |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 895 EAST MAIN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRINGTON |
| Zip Code Of The Provider | 06790 |
| 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 | 49 |
| Number Of Services | 5452 |
| Number Of Medicare Beneficiaries | 1447 |
| Total Submitted Charge Amount | 480500.6 |
| Total Medicare Allowed Amount | 339625.11 |
| Total Medicare Payment Amount | 247068.23 |
| Total Medicare Standardized Payment Amount | 231197.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 336 |
| Number Of Medicare Beneficiaries With Drug Services | 259 |
| Total Drug Submitted ChargeAmount | 8915 |
| Total Drug Medicare AllowedAmount | 4224.59 |
| Total Drug Medicare PaymentAmount | 4050.88 |
| Total Drug Medicare Standardized Payment Amount | 4050.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 5116 |
| Number Of Medicare Beneficiaries With Medical Services | 1447 |
| Total Medical Submitted Charge Amount | 471585.6 |
| Total Medical Medicare Allowed Amount | 335400.52 |
| Total Medical Medicare Payment Amount | 243017.35 |
| Total Medical Medicare Standardized Payment Amount | 227146.76 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 456 |
| Number Of Beneficiaries Age Greater 84 | 428 |
| Number Of Female Beneficiaries | 780 |
| Number Of Male Beneficiaries | 667 |
| Number Of Non Hispanic White Beneficiaries | 1358 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 907 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 540 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5219 |