| National Provider Identifier [NPI]: | 1346274255 |
| Last Name Of The Provider | GUMBARDO |
| First Name Of The Provider | ROBERT |
| 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 | 138 |
| Number Of Services | 5146 |
| Number Of Medicare Beneficiaries | 1711 |
| Total Submitted Charge Amount | 650237 |
| Total Medicare Allowed Amount | 174024.97 |
| Total Medicare Payment Amount | 132383.66 |
| Total Medicare Standardized Payment Amount | 123784.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2447 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 7797 |
| Total Drug Medicare AllowedAmount | 722.85 |
| Total Drug Medicare PaymentAmount | 516.08 |
| Total Drug Medicare Standardized Payment Amount | 516.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 2699 |
| Number Of Medicare Beneficiaries With Medical Services | 1711 |
| Total Medical Submitted Charge Amount | 642440 |
| Total Medical Medicare Allowed Amount | 173302.12 |
| Total Medical Medicare Payment Amount | 131867.58 |
| Total Medical Medicare Standardized Payment Amount | 123268.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 298 |
| Number Of Beneficiaries Age 65 to 74 | 524 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1102 |
| Number Of Male Beneficiaries | 609 |
| Number Of Non Hispanic White Beneficiaries | 1390 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 772 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| 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 | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| 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 | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7631 |