| National Provider Identifier [NPI]: | 1164432209 |
| Last Name Of The Provider | KRAVETZ |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | W |
| 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 | 060404131 |
| 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 | 184 |
| Number Of Services | 4603 |
| Number Of Medicare Beneficiaries | 2755 |
| Total Submitted Charge Amount | 671028 |
| Total Medicare Allowed Amount | 149113.71 |
| Total Medicare Payment Amount | 119762.23 |
| Total Medicare Standardized Payment Amount | 113616.68 |
| 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 | 184 |
| Number Of Medical Services | 4603 |
| Number Of Medicare Beneficiaries With Medical Services | 2755 |
| Total Medical Submitted Charge Amount | 671028 |
| Total Medical Medicare Allowed Amount | 149113.71 |
| Total Medical Medicare Payment Amount | 119762.23 |
| Total Medical Medicare Standardized Payment Amount | 113616.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 506 |
| Number Of Beneficiaries Age 65 to 74 | 905 |
| Number Of Beneficiaries Age 75 to 84 | 804 |
| Number Of Beneficiaries Age Greater 84 | 540 |
| Number Of Female Beneficiaries | 1933 |
| Number Of Male Beneficiaries | 822 |
| Number Of Non Hispanic White Beneficiaries | 2480 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | 45 |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1810 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 945 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| 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 | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5143 |