| National Provider Identifier [NPI]: | 1043232275 |
| Last Name Of The Provider | SALA |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| 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 | 146 |
| Number Of Services | 5474 |
| Number Of Medicare Beneficiaries | 2608 |
| Total Submitted Charge Amount | 484143.75 |
| Total Medicare Allowed Amount | 177581.82 |
| Total Medicare Payment Amount | 132307.01 |
| Total Medicare Standardized Payment Amount | 126273.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1429 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1510.75 |
| Total Drug Medicare AllowedAmount | 708.27 |
| Total Drug Medicare PaymentAmount | 555.3 |
| Total Drug Medicare Standardized Payment Amount | 555.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 4045 |
| Number Of Medicare Beneficiaries With Medical Services | 2607 |
| Total Medical Submitted Charge Amount | 482633 |
| Total Medical Medicare Allowed Amount | 176873.55 |
| Total Medical Medicare Payment Amount | 131751.71 |
| Total Medical Medicare Standardized Payment Amount | 125717.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 416 |
| Number Of Beneficiaries Age 65 to 74 | 734 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 635 |
| Number Of Female Beneficiaries | 1492 |
| Number Of Male Beneficiaries | 1116 |
| Number Of Non Hispanic White Beneficiaries | 1890 |
| Number Of Black or African American Beneficiaries | 430 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 198 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1559 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1049 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9957 |