| National Provider Identifier [NPI]: | 1164408357 |
| Last Name Of The Provider | ROSSHIRT |
| First Name Of The Provider | WERNER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| 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 | 169 |
| Number Of Services | 7386 |
| Number Of Medicare Beneficiaries | 2758 |
| Total Submitted Charge Amount | 1066606 |
| Total Medicare Allowed Amount | 220979.87 |
| Total Medicare Payment Amount | 166352.19 |
| Total Medicare Standardized Payment Amount | 154005.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3130 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 12971 |
| Total Drug Medicare AllowedAmount | 2043.87 |
| Total Drug Medicare PaymentAmount | 1543.43 |
| Total Drug Medicare Standardized Payment Amount | 1543.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 4256 |
| Number Of Medicare Beneficiaries With Medical Services | 2756 |
| Total Medical Submitted Charge Amount | 1053635 |
| Total Medical Medicare Allowed Amount | 218936 |
| Total Medical Medicare Payment Amount | 164808.76 |
| Total Medical Medicare Standardized Payment Amount | 152462.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 495 |
| Number Of Beneficiaries Age 65 to 74 | 948 |
| Number Of Beneficiaries Age 75 to 84 | 758 |
| Number Of Beneficiaries Age Greater 84 | 557 |
| Number Of Female Beneficiaries | 1660 |
| Number Of Male Beneficiaries | 1098 |
| Number Of Non Hispanic White Beneficiaries | 2312 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 262 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1792 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 966 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6406 |