| National Provider Identifier [NPI]: | 1578587788 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | PETER |
| 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 | 57 COMMERCIAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRINGTON |
| Zip Code Of The Provider | 067903097 |
| 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 | 185 |
| Number Of Services | 8825 |
| Number Of Medicare Beneficiaries | 2919 |
| Total Submitted Charge Amount | 1112943.95 |
| Total Medicare Allowed Amount | 337243.27 |
| Total Medicare Payment Amount | 261913.38 |
| Total Medicare Standardized Payment Amount | 242692.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2868 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 8131.95 |
| Total Drug Medicare AllowedAmount | 2659.25 |
| Total Drug Medicare PaymentAmount | 2084.9 |
| Total Drug Medicare Standardized Payment Amount | 2084.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 181 |
| Number Of Medical Services | 5957 |
| Number Of Medicare Beneficiaries With Medical Services | 2919 |
| Total Medical Submitted Charge Amount | 1104812 |
| Total Medical Medicare Allowed Amount | 334584.02 |
| Total Medical Medicare Payment Amount | 259828.48 |
| Total Medical Medicare Standardized Payment Amount | 240607.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 470 |
| Number Of Beneficiaries Age 65 to 74 | 967 |
| Number Of Beneficiaries Age 75 to 84 | 873 |
| Number Of Beneficiaries Age Greater 84 | 609 |
| Number Of Female Beneficiaries | 2056 |
| Number Of Male Beneficiaries | 863 |
| Number Of Non Hispanic White Beneficiaries | 2761 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1838 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1081 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4083 |