| National Provider Identifier [NPI]: | 1639150618 |
| Last Name Of The Provider | ISRAEL |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 YORK ST |
| Street Address 2 Of The Provider | YNHH SOUTH PAVILION - 2ND FLOOR |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 065103220 |
| 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 | 53 |
| Number Of Services | 2130 |
| Number Of Medicare Beneficiaries | 1433 |
| Total Submitted Charge Amount | 697930 |
| Total Medicare Allowed Amount | 133182.64 |
| Total Medicare Payment Amount | 101863.43 |
| Total Medicare Standardized Payment Amount | 97059.58 |
| 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 | 53 |
| Number Of Medical Services | 2130 |
| Number Of Medicare Beneficiaries With Medical Services | 1433 |
| Total Medical Submitted Charge Amount | 697930 |
| Total Medical Medicare Allowed Amount | 133182.64 |
| Total Medical Medicare Payment Amount | 101863.43 |
| Total Medical Medicare Standardized Payment Amount | 97059.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 281 |
| Number Of Beneficiaries Age 65 to 74 | 541 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 767 |
| Number Of Male Beneficiaries | 666 |
| Number Of Non Hispanic White Beneficiaries | 1108 |
| Number Of Black or African American Beneficiaries | 182 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 924 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.215 |