| National Provider Identifier [NPI]: | 1790808095 |
| Last Name Of The Provider | MEI |
| First Name Of The Provider | JOHNNY |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 64 ROBBINS ST |
| Street Address 2 Of The Provider | DEPARTMENT OF HOSPITALIST |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 067082613 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1671 |
| Number Of Medicare Beneficiaries | 589 |
| Total Submitted Charge Amount | 336937.5 |
| Total Medicare Allowed Amount | 163470.04 |
| Total Medicare Payment Amount | 126745.19 |
| Total Medicare Standardized Payment Amount | 119985.88 |
| 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 | 22 |
| Number Of Medical Services | 1671 |
| Number Of Medicare Beneficiaries With Medical Services | 589 |
| Total Medical Submitted Charge Amount | 336937.5 |
| Total Medical Medicare Allowed Amount | 163470.04 |
| Total Medical Medicare Payment Amount | 126745.19 |
| Total Medical Medicare Standardized Payment Amount | 119985.88 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 280 |
| Number Of Non Hispanic White Beneficiaries | 499 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 299 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4815 |