| National Provider Identifier [NPI]: | 1124013792 |
| Last Name Of The Provider | SHIMKIN |
| First Name Of The Provider | PETER |
| 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 | 56 QUARRY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRUMBULL |
| Zip Code Of The Provider | 066114874 |
| 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 | 114 |
| Number Of Services | 14628 |
| Number Of Medicare Beneficiaries | 1310 |
| Total Submitted Charge Amount | 1015849.65 |
| Total Medicare Allowed Amount | 243296.23 |
| Total Medicare Payment Amount | 185812.97 |
| Total Medicare Standardized Payment Amount | 175670.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12968 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 11097.65 |
| Total Drug Medicare AllowedAmount | 3809.8 |
| Total Drug Medicare PaymentAmount | 2960.83 |
| Total Drug Medicare Standardized Payment Amount | 2960.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 1660 |
| Number Of Medicare Beneficiaries With Medical Services | 1310 |
| Total Medical Submitted Charge Amount | 1004752 |
| Total Medical Medicare Allowed Amount | 239486.43 |
| Total Medical Medicare Payment Amount | 182852.14 |
| Total Medical Medicare Standardized Payment Amount | 172709.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 464 |
| Number Of Beneficiaries Age 75 to 84 | 443 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 756 |
| Number Of Male Beneficiaries | 554 |
| Number Of Non Hispanic White Beneficiaries | 1038 |
| Number Of Black or African American Beneficiaries | 113 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 972 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4235 |