| National Provider Identifier [NPI]: | 1306159819 |
| Last Name Of The Provider | WADDINGTON |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 HARTFORD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 060405921 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 281 |
| Number Of Medicare Beneficiaries | 162 |
| Total Submitted Charge Amount | 33933 |
| Total Medicare Allowed Amount | 21485.51 |
| Total Medicare Payment Amount | 17166.06 |
| Total Medicare Standardized Payment Amount | 16128.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 845 |
| Total Drug Medicare AllowedAmount | 517.31 |
| Total Drug Medicare PaymentAmount | 505.51 |
| Total Drug Medicare Standardized Payment Amount | 505.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 262 |
| Number Of Medicare Beneficiaries With Medical Services | 162 |
| Total Medical Submitted Charge Amount | 33088 |
| Total Medical Medicare Allowed Amount | 20968.2 |
| Total Medical Medicare Payment Amount | 16660.55 |
| Total Medical Medicare Standardized Payment Amount | 15622.61 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3459 |