| National Provider Identifier [NPI]: | 1609848480 |
| Last Name Of The Provider | SNOWBALL |
| First Name Of The Provider | HALINA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 GREENWICH OFFICE PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENWICH |
| Zip Code Of The Provider | 068315151 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 7268 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 1504195.3 |
| Total Medicare Allowed Amount | 411998.69 |
| Total Medicare Payment Amount | 315860.57 |
| Total Medicare Standardized Payment Amount | 303216.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2949 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 207715 |
| Total Drug Medicare AllowedAmount | 101168.34 |
| Total Drug Medicare PaymentAmount | 78991.93 |
| Total Drug Medicare Standardized Payment Amount | 78991.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 4319 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 1296480.3 |
| Total Medical Medicare Allowed Amount | 310830.35 |
| Total Medical Medicare Payment Amount | 236868.64 |
| Total Medical Medicare Standardized Payment Amount | 224224.38 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 146 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.009 |