| National Provider Identifier [NPI]: | 1205833878 |
| Last Name Of The Provider | PACKER |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 191 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 060423556 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 16933 |
| Number Of Medicare Beneficiaries | 1295 |
| Total Submitted Charge Amount | 5835367.5 |
| Total Medicare Allowed Amount | 3914516.44 |
| Total Medicare Payment Amount | 3008492.29 |
| Total Medicare Standardized Payment Amount | 2942700.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 6076 |
| Number Of Medicare Beneficiaries With Drug Services | 336 |
| Total Drug Submitted ChargeAmount | 3175502.5 |
| Total Drug Medicare AllowedAmount | 2786415.97 |
| Total Drug Medicare PaymentAmount | 2165776.78 |
| Total Drug Medicare Standardized Payment Amount | 2165776.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 10857 |
| Number Of Medicare Beneficiaries With Medical Services | 1295 |
| Total Medical Submitted Charge Amount | 2659865 |
| Total Medical Medicare Allowed Amount | 1128100.47 |
| Total Medical Medicare Payment Amount | 842715.51 |
| Total Medical Medicare Standardized Payment Amount | 776923.84 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 406 |
| Number Of Beneficiaries Age 75 to 84 | 437 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 767 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 1143 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1032 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2758 |