| National Provider Identifier [NPI]: | 1124026232 |
| Last Name Of The Provider | GORENBEYN |
| First Name Of The Provider | ALEKSANDR |
| 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 | 396 CROMWELL AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKY HILL |
| Zip Code Of The Provider | 060671841 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 993 |
| Number Of Medicare Beneficiaries | 657 |
| Total Submitted Charge Amount | 174408.88 |
| Total Medicare Allowed Amount | 73921.87 |
| Total Medicare Payment Amount | 56557.84 |
| Total Medicare Standardized Payment Amount | 53130.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 5618 |
| Total Drug Medicare AllowedAmount | 2968.83 |
| Total Drug Medicare PaymentAmount | 2896.44 |
| Total Drug Medicare Standardized Payment Amount | 2896.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 829 |
| Number Of Medicare Beneficiaries With Medical Services | 657 |
| Total Medical Submitted Charge Amount | 168790.88 |
| Total Medical Medicare Allowed Amount | 70953.04 |
| Total Medical Medicare Payment Amount | 53661.4 |
| Total Medical Medicare Standardized Payment Amount | 50234.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 398 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 571 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3553 |