| National Provider Identifier [NPI]: | 1407893183 |
| Last Name Of The Provider | SORRENTINO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 365 MONTAUK AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW LONDON |
| Zip Code Of The Provider | 06320 |
| 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 | 137 |
| Number Of Services | 6629 |
| Number Of Medicare Beneficiaries | 3959 |
| Total Submitted Charge Amount | 722206 |
| Total Medicare Allowed Amount | 169378.42 |
| Total Medicare Payment Amount | 130234.14 |
| Total Medicare Standardized Payment Amount | 125208.9 |
| 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 | 137 |
| Number Of Medical Services | 6629 |
| Number Of Medicare Beneficiaries With Medical Services | 3959 |
| Total Medical Submitted Charge Amount | 722206 |
| Total Medical Medicare Allowed Amount | 169378.42 |
| Total Medical Medicare Payment Amount | 130234.14 |
| Total Medical Medicare Standardized Payment Amount | 125208.9 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 604 |
| Number Of Beneficiaries Age 65 to 74 | 1388 |
| Number Of Beneficiaries Age 75 to 84 | 1207 |
| Number Of Beneficiaries Age Greater 84 | 760 |
| Number Of Female Beneficiaries | 2531 |
| Number Of Male Beneficiaries | 1428 |
| Number Of Non Hispanic White Beneficiaries | 3398 |
| Number Of Black or African American Beneficiaries | 221 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 178 |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 72 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1198 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5612 |