| National Provider Identifier [NPI]: | 1225074412 |
| Last Name Of The Provider | BERNS |
| First Name Of The Provider | ELLISON |
| 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 | 1000 ASYLUM AVE |
| Street Address 2 Of The Provider | SUITE 3206 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061051770 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 2740 |
| Number Of Medicare Beneficiaries | 471 |
| Total Submitted Charge Amount | 631293.02 |
| Total Medicare Allowed Amount | 243051.61 |
| Total Medicare Payment Amount | 182535.26 |
| Total Medicare Standardized Payment Amount | 173281 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2740 |
| Number Of Medicare Beneficiaries With Medical Services | 471 |
| Total Medical Submitted Charge Amount | 631293.02 |
| Total Medical Medicare Allowed Amount | 243051.61 |
| Total Medical Medicare Payment Amount | 182535.26 |
| Total Medical Medicare Standardized Payment Amount | 173281 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 99 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 305 |
| Number Of Non Hispanic White Beneficiaries | 402 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 351 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 52 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 73 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9823 |