| National Provider Identifier [NPI]: | 1912290883 |
| Last Name Of The Provider | HERBST |
| First Name Of The Provider | TIMOTHY |
| 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 | 111 FOUNDERS PLZ |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | EAST HARTFORD |
| Zip Code Of The Provider | 061083212 |
| 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 | 154 |
| Number Of Services | 11608 |
| Number Of Medicare Beneficiaries | 4184 |
| Total Submitted Charge Amount | 992181 |
| Total Medicare Allowed Amount | 240295.33 |
| Total Medicare Payment Amount | 182210.67 |
| Total Medicare Standardized Payment Amount | 174862.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5022 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 15790 |
| Total Drug Medicare AllowedAmount | 1024.7 |
| Total Drug Medicare PaymentAmount | 793.3 |
| Total Drug Medicare Standardized Payment Amount | 793.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 6586 |
| Number Of Medicare Beneficiaries With Medical Services | 4184 |
| Total Medical Submitted Charge Amount | 976391 |
| Total Medical Medicare Allowed Amount | 239270.63 |
| Total Medical Medicare Payment Amount | 181417.37 |
| Total Medical Medicare Standardized Payment Amount | 174069.47 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 857 |
| Number Of Beneficiaries Age 65 to 74 | 1142 |
| Number Of Beneficiaries Age 75 to 84 | 1176 |
| Number Of Beneficiaries Age Greater 84 | 1009 |
| Number Of Female Beneficiaries | 2360 |
| Number Of Male Beneficiaries | 1824 |
| Number Of Non Hispanic White Beneficiaries | 3417 |
| Number Of Black or African American Beneficiaries | 232 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 422 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1798 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1002 |