| National Provider Identifier [NPI]: | 1518953389 |
| Last Name Of The Provider | ZIEWACZ |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 114 WOODLAND ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061051208 |
| 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 | 127 |
| Number Of Services | 17802 |
| Number Of Medicare Beneficiaries | 3805 |
| Total Submitted Charge Amount | 972429.9 |
| Total Medicare Allowed Amount | 381624.96 |
| Total Medicare Payment Amount | 307630.38 |
| Total Medicare Standardized Payment Amount | 287135.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11338 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 5195.9 |
| Total Drug Medicare AllowedAmount | 2151.68 |
| Total Drug Medicare PaymentAmount | 1686.96 |
| Total Drug Medicare Standardized Payment Amount | 1686.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 6464 |
| Number Of Medicare Beneficiaries With Medical Services | 3804 |
| Total Medical Submitted Charge Amount | 967234 |
| Total Medical Medicare Allowed Amount | 379473.28 |
| Total Medical Medicare Payment Amount | 305943.42 |
| Total Medical Medicare Standardized Payment Amount | 285448.82 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 536 |
| Number Of Beneficiaries Age 65 to 74 | 1324 |
| Number Of Beneficiaries Age 75 to 84 | 1227 |
| Number Of Beneficiaries Age Greater 84 | 718 |
| Number Of Female Beneficiaries | 2690 |
| Number Of Male Beneficiaries | 1115 |
| Number Of Non Hispanic White Beneficiaries | 2830 |
| Number Of Black or African American Beneficiaries | 571 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 278 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 71 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2509 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1296 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6678 |