| National Provider Identifier [NPI]: | 1679795538 |
| Last Name Of The Provider | BLOUNT |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 FOUNDERS PLZ |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | EAST HARTFORD |
| Zip Code Of The Provider | 061083212 |
| 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 | 107 |
| Number Of Services | 2955 |
| Number Of Medicare Beneficiaries | 1973 |
| Total Submitted Charge Amount | 454471 |
| Total Medicare Allowed Amount | 83973.51 |
| Total Medicare Payment Amount | 63926.99 |
| Total Medicare Standardized Payment Amount | 60078.83 |
| 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 | 107 |
| Number Of Medical Services | 2955 |
| Number Of Medicare Beneficiaries With Medical Services | 1973 |
| Total Medical Submitted Charge Amount | 454471 |
| Total Medical Medicare Allowed Amount | 83973.51 |
| Total Medical Medicare Payment Amount | 63926.99 |
| Total Medical Medicare Standardized Payment Amount | 60078.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 364 |
| Number Of Beneficiaries Age 65 to 74 | 845 |
| Number Of Beneficiaries Age 75 to 84 | 538 |
| Number Of Beneficiaries Age Greater 84 | 226 |
| Number Of Female Beneficiaries | 1210 |
| Number Of Male Beneficiaries | 763 |
| Number Of Non Hispanic White Beneficiaries | 1299 |
| Number Of Black or African American Beneficiaries | 439 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 140 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1529 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 444 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7162 |