| National Provider Identifier [NPI]: | 1114959541 |
| Last Name Of The Provider | BUSHEY |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 385 MAIN ST SOUTH |
| Street Address 2 Of The Provider | UNION SQUARE |
| City Of The Provider | SOUTHBURY |
| Zip Code Of The Provider | 06488 |
| 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 | 7969 |
| Number Of Medicare Beneficiaries | 2148 |
| Total Submitted Charge Amount | 927710 |
| Total Medicare Allowed Amount | 246501.52 |
| Total Medicare Payment Amount | 188187.79 |
| Total Medicare Standardized Payment Amount | 175200.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4389 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 14967 |
| Total Drug Medicare AllowedAmount | 1901.03 |
| Total Drug Medicare PaymentAmount | 1329.99 |
| Total Drug Medicare Standardized Payment Amount | 1329.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 3580 |
| Number Of Medicare Beneficiaries With Medical Services | 2148 |
| Total Medical Submitted Charge Amount | 912743 |
| Total Medical Medicare Allowed Amount | 244600.49 |
| Total Medical Medicare Payment Amount | 186857.8 |
| Total Medical Medicare Standardized Payment Amount | 173870.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 673 |
| Number Of Beneficiaries Age 75 to 84 | 639 |
| Number Of Beneficiaries Age Greater 84 | 423 |
| Number Of Female Beneficiaries | 1345 |
| Number Of Male Beneficiaries | 803 |
| Number Of Non Hispanic White Beneficiaries | 1723 |
| Number Of Black or African American Beneficiaries | 156 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 214 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 962 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7731 |