| National Provider Identifier [NPI]: | 1770547952 |
| Last Name Of The Provider | CEMENTINA |
| First Name Of The Provider | ALAN |
| 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 | 99 WOODLAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061051207 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 507 |
| Number Of Medicare Beneficiaries | 210 |
| Total Submitted Charge Amount | 45831.32 |
| Total Medicare Allowed Amount | 31118.85 |
| Total Medicare Payment Amount | 22318.44 |
| Total Medicare Standardized Payment Amount | 20861.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1036.32 |
| Total Drug Medicare AllowedAmount | 781.38 |
| Total Drug Medicare PaymentAmount | 764.77 |
| Total Drug Medicare Standardized Payment Amount | 764.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 472 |
| Number Of Medicare Beneficiaries With Medical Services | 210 |
| Total Medical Submitted Charge Amount | 44795 |
| Total Medical Medicare Allowed Amount | 30337.47 |
| Total Medical Medicare Payment Amount | 21553.67 |
| Total Medical Medicare Standardized Payment Amount | 20096.56 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4836 |