| National Provider Identifier [NPI]: | 1578573606 |
| Last Name Of The Provider | DENSTMAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 71 HAYNES ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 06040 |
| 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 | 207 |
| Number Of Services | 5300 |
| Number Of Medicare Beneficiaries | 3149 |
| Total Submitted Charge Amount | 800219 |
| Total Medicare Allowed Amount | 178276.6 |
| Total Medicare Payment Amount | 144404.4 |
| Total Medicare Standardized Payment Amount | 136893.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 207 |
| Number Of Medical Services | 5300 |
| Number Of Medicare Beneficiaries With Medical Services | 3149 |
| Total Medical Submitted Charge Amount | 800219 |
| Total Medical Medicare Allowed Amount | 178276.6 |
| Total Medical Medicare Payment Amount | 144404.4 |
| Total Medical Medicare Standardized Payment Amount | 136893.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 514 |
| Number Of Beneficiaries Age 65 to 74 | 1085 |
| Number Of Beneficiaries Age 75 to 84 | 922 |
| Number Of Beneficiaries Age Greater 84 | 628 |
| Number Of Female Beneficiaries | 2235 |
| Number Of Male Beneficiaries | 914 |
| Number Of Non Hispanic White Beneficiaries | 2841 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 123 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1006 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4779 |