| National Provider Identifier [NPI]: | 1245297654 |
| Last Name Of The Provider | DELEON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 134 GRANDVIEW AVE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 06708 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 8196 |
| Number Of Medicare Beneficiaries | 2689 |
| Total Submitted Charge Amount | 1126738 |
| Total Medicare Allowed Amount | 278023.42 |
| Total Medicare Payment Amount | 217857.54 |
| Total Medicare Standardized Payment Amount | 204435.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3308 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 4522 |
| Total Drug Medicare AllowedAmount | 1695.58 |
| Total Drug Medicare PaymentAmount | 1329.33 |
| Total Drug Medicare Standardized Payment Amount | 1329.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 4888 |
| Number Of Medicare Beneficiaries With Medical Services | 2689 |
| Total Medical Submitted Charge Amount | 1122216 |
| Total Medical Medicare Allowed Amount | 276327.84 |
| Total Medical Medicare Payment Amount | 216528.21 |
| Total Medical Medicare Standardized Payment Amount | 203106.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 536 |
| Number Of Beneficiaries Age 65 to 74 | 830 |
| Number Of Beneficiaries Age 75 to 84 | 737 |
| Number Of Beneficiaries Age Greater 84 | 586 |
| Number Of Female Beneficiaries | 1692 |
| Number Of Male Beneficiaries | 997 |
| Number Of Non Hispanic White Beneficiaries | 2252 |
| Number Of Black or African American Beneficiaries | 184 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 190 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1518 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1171 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.683 |