| National Provider Identifier [NPI]: | 1417934860 |
| Last Name Of The Provider | ULREICH |
| First Name Of The Provider | SIDNEY |
| 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 | 100 GRAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BRITAIN |
| Zip Code Of The Provider | 060522016 |
| 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 | 155 |
| Number Of Services | 4899 |
| Number Of Medicare Beneficiaries | 2697 |
| Total Submitted Charge Amount | 298855.54 |
| Total Medicare Allowed Amount | 92608.63 |
| Total Medicare Payment Amount | 70490.13 |
| Total Medicare Standardized Payment Amount | 67057.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 4899 |
| Number Of Medicare Beneficiaries With Medical Services | 2697 |
| Total Medical Submitted Charge Amount | 298855.54 |
| Total Medical Medicare Allowed Amount | 92608.63 |
| Total Medical Medicare Payment Amount | 70490.13 |
| Total Medical Medicare Standardized Payment Amount | 67057.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 578 |
| Number Of Beneficiaries Age 65 to 74 | 723 |
| Number Of Beneficiaries Age 75 to 84 | 756 |
| Number Of Beneficiaries Age Greater 84 | 640 |
| Number Of Female Beneficiaries | 1739 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 2175 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 319 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1273 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.887 |