| National Provider Identifier [NPI]: | 1366409757 |
| Last Name Of The Provider | HYSON |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 134 GRANDVIEW AVE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 06708 |
| 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 | 253 |
| Number Of Services | 3820 |
| Number Of Medicare Beneficiaries | 1465 |
| Total Submitted Charge Amount | 630924 |
| Total Medicare Allowed Amount | 171157.97 |
| Total Medicare Payment Amount | 136652.28 |
| Total Medicare Standardized Payment Amount | 128071.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1103 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1409 |
| Total Drug Medicare AllowedAmount | 384.54 |
| Total Drug Medicare PaymentAmount | 289.93 |
| Total Drug Medicare Standardized Payment Amount | 289.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 249 |
| Number Of Medical Services | 2717 |
| Number Of Medicare Beneficiaries With Medical Services | 1465 |
| Total Medical Submitted Charge Amount | 629515 |
| Total Medical Medicare Allowed Amount | 170773.43 |
| Total Medical Medicare Payment Amount | 136362.35 |
| Total Medical Medicare Standardized Payment Amount | 127781.25 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 270 |
| Number Of Beneficiaries Age 65 to 74 | 438 |
| Number Of Beneficiaries Age 75 to 84 | 445 |
| Number Of Beneficiaries Age Greater 84 | 312 |
| Number Of Female Beneficiaries | 924 |
| Number Of Male Beneficiaries | 541 |
| Number Of Non Hispanic White Beneficiaries | 1237 |
| Number Of Black or African American Beneficiaries | 102 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 812 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 653 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8323 |