| National Provider Identifier [NPI]: | 1356335707 |
| Last Name Of The Provider | RUDOLPH |
| First Name Of The Provider | DANIEL |
| 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 | 15 CORPORATE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRUMBULL |
| Zip Code Of The Provider | 066111351 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 3832 |
| Number Of Medicare Beneficiaries | 840 |
| Total Submitted Charge Amount | 648369 |
| Total Medicare Allowed Amount | 309011.27 |
| Total Medicare Payment Amount | 234738.05 |
| Total Medicare Standardized Payment Amount | 221984.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 128 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 11380 |
| Total Drug Medicare AllowedAmount | 5673.43 |
| Total Drug Medicare PaymentAmount | 5558.37 |
| Total Drug Medicare Standardized Payment Amount | 5558.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3704 |
| Number Of Medicare Beneficiaries With Medical Services | 840 |
| Total Medical Submitted Charge Amount | 636989 |
| Total Medical Medicare Allowed Amount | 303337.84 |
| Total Medical Medicare Payment Amount | 229179.68 |
| Total Medical Medicare Standardized Payment Amount | 216426.6 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 286 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 335 |
| Number Of Non Hispanic White Beneficiaries | 722 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8987 |