| National Provider Identifier [NPI]: | 1255310504 |
| Last Name Of The Provider | REABACK |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 HEBRON AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | GLASTONBURY |
| Zip Code Of The Provider | 060332176 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2820 |
| Number Of Medicare Beneficiaries | 627 |
| Total Submitted Charge Amount | 282903.28 |
| Total Medicare Allowed Amount | 160130 |
| Total Medicare Payment Amount | 112856.8 |
| Total Medicare Standardized Payment Amount | 105190.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 3973.28 |
| Total Drug Medicare AllowedAmount | 3350.16 |
| Total Drug Medicare PaymentAmount | 2578.51 |
| Total Drug Medicare Standardized Payment Amount | 2578.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2696 |
| Number Of Medicare Beneficiaries With Medical Services | 627 |
| Total Medical Submitted Charge Amount | 278930 |
| Total Medical Medicare Allowed Amount | 156779.84 |
| Total Medical Medicare Payment Amount | 110278.29 |
| Total Medical Medicare Standardized Payment Amount | 102611.59 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 199 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 419 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 599 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6688 |