| National Provider Identifier [NPI]: | 1700860699 |
| Last Name Of The Provider | DEY |
| First Name Of The Provider | HOLLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 16364 |
| Number Of Medicare Beneficiaries | 2736 |
| Total Submitted Charge Amount | 848162.82 |
| Total Medicare Allowed Amount | 309740.04 |
| Total Medicare Payment Amount | 242190.01 |
| Total Medicare Standardized Payment Amount | 227020.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 11600 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 11600 |
| Total Drug Medicare AllowedAmount | 2133.51 |
| Total Drug Medicare PaymentAmount | 1582.78 |
| Total Drug Medicare Standardized Payment Amount | 1582.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 4764 |
| Number Of Medicare Beneficiaries With Medical Services | 2736 |
| Total Medical Submitted Charge Amount | 836562.82 |
| Total Medical Medicare Allowed Amount | 307606.53 |
| Total Medical Medicare Payment Amount | 240607.23 |
| Total Medical Medicare Standardized Payment Amount | 225438.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 416 |
| Number Of Beneficiaries Age 65 to 74 | 776 |
| Number Of Beneficiaries Age 75 to 84 | 801 |
| Number Of Beneficiaries Age Greater 84 | 743 |
| Number Of Female Beneficiaries | 1836 |
| Number Of Male Beneficiaries | 900 |
| Number Of Non Hispanic White Beneficiaries | 2383 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 202 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1701 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1035 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6167 |