| National Provider Identifier [NPI]: | 1548271463 |
| Last Name Of The Provider | SPOSATO |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 98 MAIN ST |
| Street Address 2 Of The Provider | MIDSTATE MEDICAL GROUP |
| City Of The Provider | SOUTHINGTON |
| Zip Code Of The Provider | 064892500 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 693 |
| Number Of Medicare Beneficiaries | 311 |
| Total Submitted Charge Amount | 106623 |
| Total Medicare Allowed Amount | 48151.62 |
| Total Medicare Payment Amount | 35756.34 |
| Total Medicare Standardized Payment Amount | 39324.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 1549 |
| Total Drug Medicare AllowedAmount | 1057.12 |
| Total Drug Medicare PaymentAmount | 1016.33 |
| Total Drug Medicare Standardized Payment Amount | 1016.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 629 |
| Number Of Medicare Beneficiaries With Medical Services | 310 |
| Total Medical Submitted Charge Amount | 105074 |
| Total Medical Medicare Allowed Amount | 47094.5 |
| Total Medical Medicare Payment Amount | 34740.01 |
| Total Medical Medicare Standardized Payment Amount | 38308.16 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 269 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 184 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2792 |