| National Provider Identifier [NPI]: | 1104896224 |
| Last Name Of The Provider | FUCCI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 79 WAWECUS ST |
| Street Address 2 Of The Provider | SUITE #106 |
| City Of The Provider | NORWICH |
| Zip Code Of The Provider | 063602160 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 3630 |
| Number Of Medicare Beneficiaries | 1888 |
| Total Submitted Charge Amount | 1016648 |
| Total Medicare Allowed Amount | 320503.88 |
| Total Medicare Payment Amount | 237163.53 |
| Total Medicare Standardized Payment Amount | 225833.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 240 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 14960 |
| Total Drug Medicare AllowedAmount | 12703.93 |
| Total Drug Medicare PaymentAmount | 9794.06 |
| Total Drug Medicare Standardized Payment Amount | 9794.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 3390 |
| Number Of Medicare Beneficiaries With Medical Services | 1888 |
| Total Medical Submitted Charge Amount | 1001688 |
| Total Medical Medicare Allowed Amount | 307799.95 |
| Total Medical Medicare Payment Amount | 227369.47 |
| Total Medical Medicare Standardized Payment Amount | 216039.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 641 |
| Number Of Beneficiaries Age 75 to 84 | 633 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 947 |
| Number Of Male Beneficiaries | 941 |
| Number Of Non Hispanic White Beneficiaries | 1663 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 654 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9214 |