| National Provider Identifier [NPI]: | 1396770111 |
| Last Name Of The Provider | POOLE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 FOUNDERS PLZ |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | EAST HARTFORD |
| Zip Code Of The Provider | 061083212 |
| 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 | 121 |
| Number Of Services | 8894 |
| Number Of Medicare Beneficiaries | 4062 |
| Total Submitted Charge Amount | 1381446 |
| Total Medicare Allowed Amount | 374049.95 |
| Total Medicare Payment Amount | 302635.43 |
| Total Medicare Standardized Payment Amount | 279962.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2550 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 7650 |
| Total Drug Medicare AllowedAmount | 648.45 |
| Total Drug Medicare PaymentAmount | 508.37 |
| Total Drug Medicare Standardized Payment Amount | 508.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 6344 |
| Number Of Medicare Beneficiaries With Medical Services | 4062 |
| Total Medical Submitted Charge Amount | 1373796 |
| Total Medical Medicare Allowed Amount | 373401.5 |
| Total Medical Medicare Payment Amount | 302127.06 |
| Total Medical Medicare Standardized Payment Amount | 279454.48 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 989 |
| Number Of Beneficiaries Age 65 to 74 | 1410 |
| Number Of Beneficiaries Age 75 to 84 | 1081 |
| Number Of Beneficiaries Age Greater 84 | 582 |
| Number Of Female Beneficiaries | 2890 |
| Number Of Male Beneficiaries | 1172 |
| Number Of Non Hispanic White Beneficiaries | 3439 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 351 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2593 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1469 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3857 |