| National Provider Identifier [NPI]: | 1588694210 |
| Last Name Of The Provider | BOCCELLI |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 116 E CENTER ST |
| Street Address 2 Of The Provider | SUITE 10 |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 060405215 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2254 |
| Number Of Medicare Beneficiaries | 655 |
| Total Submitted Charge Amount | 336624 |
| Total Medicare Allowed Amount | 180161.56 |
| Total Medicare Payment Amount | 131264.86 |
| Total Medicare Standardized Payment Amount | 121805.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 470 |
| Total Drug Medicare AllowedAmount | 166.99 |
| Total Drug Medicare PaymentAmount | 130.76 |
| Total Drug Medicare Standardized Payment Amount | 130.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2160 |
| Number Of Medicare Beneficiaries With Medical Services | 655 |
| Total Medical Submitted Charge Amount | 336154 |
| Total Medical Medicare Allowed Amount | 179994.57 |
| Total Medical Medicare Payment Amount | 131134.1 |
| Total Medical Medicare Standardized Payment Amount | 121675.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 221 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 426 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 613 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 502 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3542 |