| National Provider Identifier [NPI]: | 1578761391 |
| Last Name Of The Provider | MOLINA |
| First Name Of The Provider | MARCO |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 263 FARMINGTON AVE |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 060302803 |
| 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 | 101 |
| Number Of Services | 1994 |
| Number Of Medicare Beneficiaries | 1327 |
| Total Submitted Charge Amount | 304630 |
| Total Medicare Allowed Amount | 103367.95 |
| Total Medicare Payment Amount | 79673.88 |
| Total Medicare Standardized Payment Amount | 76029.32 |
| 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 | 101 |
| Number Of Medical Services | 1994 |
| Number Of Medicare Beneficiaries With Medical Services | 1327 |
| Total Medical Submitted Charge Amount | 304630 |
| Total Medical Medicare Allowed Amount | 103367.95 |
| Total Medical Medicare Payment Amount | 79673.88 |
| Total Medical Medicare Standardized Payment Amount | 76029.32 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 277 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 380 |
| Number Of Beneficiaries Age Greater 84 | 306 |
| Number Of Female Beneficiaries | 790 |
| Number Of Male Beneficiaries | 537 |
| Number Of Non Hispanic White Beneficiaries | 1087 |
| Number Of Black or African American Beneficiaries | 113 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 826 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 501 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7876 |