| National Provider Identifier [NPI]: | 1003892340 |
| Last Name Of The Provider | OPALACZ |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| 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 | 181 |
| Number Of Services | 17444 |
| Number Of Medicare Beneficiaries | 3891 |
| Total Submitted Charge Amount | 1850948 |
| Total Medicare Allowed Amount | 433003.55 |
| Total Medicare Payment Amount | 345821.52 |
| Total Medicare Standardized Payment Amount | 321153.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 11718 |
| Number Of Medicare Beneficiaries With Drug Services | 159 |
| Total Drug Submitted ChargeAmount | 38334 |
| Total Drug Medicare AllowedAmount | 4084.68 |
| Total Drug Medicare PaymentAmount | 3202.4 |
| Total Drug Medicare Standardized Payment Amount | 3202.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 5726 |
| Number Of Medicare Beneficiaries With Medical Services | 3891 |
| Total Medical Submitted Charge Amount | 1812614 |
| Total Medical Medicare Allowed Amount | 428918.87 |
| Total Medical Medicare Payment Amount | 342619.12 |
| Total Medical Medicare Standardized Payment Amount | 317951.5 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 551 |
| Number Of Beneficiaries Age 65 to 74 | 1511 |
| Number Of Beneficiaries Age 75 to 84 | 1170 |
| Number Of Beneficiaries Age Greater 84 | 659 |
| Number Of Female Beneficiaries | 2598 |
| Number Of Male Beneficiaries | 1293 |
| Number Of Non Hispanic White Beneficiaries | 3356 |
| Number Of Black or African American Beneficiaries | 164 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 262 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2729 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1162 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4963 |