| National Provider Identifier [NPI]: | 1528025913 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 134 GRANDVIEW AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 06708 |
| 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 | 172 |
| Number Of Services | 10545 |
| Number Of Medicare Beneficiaries | 2855 |
| Total Submitted Charge Amount | 1432765 |
| Total Medicare Allowed Amount | 346555.8 |
| Total Medicare Payment Amount | 271030.31 |
| Total Medicare Standardized Payment Amount | 255427.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5200 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 7178 |
| Total Drug Medicare AllowedAmount | 2704.97 |
| Total Drug Medicare PaymentAmount | 2107.75 |
| Total Drug Medicare Standardized Payment Amount | 2107.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 5345 |
| Number Of Medicare Beneficiaries With Medical Services | 2855 |
| Total Medical Submitted Charge Amount | 1425587 |
| Total Medical Medicare Allowed Amount | 343850.83 |
| Total Medical Medicare Payment Amount | 268922.56 |
| Total Medical Medicare Standardized Payment Amount | 253320.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 594 |
| Number Of Beneficiaries Age 65 to 74 | 888 |
| Number Of Beneficiaries Age 75 to 84 | 778 |
| Number Of Beneficiaries Age Greater 84 | 595 |
| Number Of Female Beneficiaries | 1733 |
| Number Of Male Beneficiaries | 1122 |
| Number Of Non Hispanic White Beneficiaries | 2398 |
| Number Of Black or African American Beneficiaries | 183 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 220 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1598 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1257 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6751 |