| National Provider Identifier [NPI]: | 1720017049 |
| Last Name Of The Provider | SPIVACK |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 97 BARNES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WALLINGFORD |
| Zip Code Of The Provider | 064921885 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 6943 |
| Number Of Medicare Beneficiaries | 2312 |
| Total Submitted Charge Amount | 1055108.69 |
| Total Medicare Allowed Amount | 466371.62 |
| Total Medicare Payment Amount | 346438.27 |
| Total Medicare Standardized Payment Amount | 326379.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 320 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 32000 |
| Total Drug Medicare AllowedAmount | 16941.83 |
| Total Drug Medicare PaymentAmount | 13159.66 |
| Total Drug Medicare Standardized Payment Amount | 13159.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 6623 |
| Number Of Medicare Beneficiaries With Medical Services | 2312 |
| Total Medical Submitted Charge Amount | 1023108.69 |
| Total Medical Medicare Allowed Amount | 449429.79 |
| Total Medical Medicare Payment Amount | 333278.61 |
| Total Medical Medicare Standardized Payment Amount | 313219.39 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 295 |
| Number Of Beneficiaries Age 65 to 74 | 631 |
| Number Of Beneficiaries Age 75 to 84 | 701 |
| Number Of Beneficiaries Age Greater 84 | 685 |
| Number Of Female Beneficiaries | 1305 |
| Number Of Male Beneficiaries | 1007 |
| Number Of Non Hispanic White Beneficiaries | 1994 |
| Number Of Black or African American Beneficiaries | 99 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 166 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1412 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 900 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8592 |