| National Provider Identifier [NPI]: | 1710094396 |
| Last Name Of The Provider | COOLBAUGH |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | MILFORD HOSPITAL |
| Street Address 2 Of The Provider | 14 PROSPECT STREET, RADIOLOGY |
| City Of The Provider | MILFORD |
| Zip Code Of The Provider | 01757 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 5927 |
| Number Of Medicare Beneficiaries | 3188 |
| Total Submitted Charge Amount | 523827 |
| Total Medicare Allowed Amount | 144943.6 |
| Total Medicare Payment Amount | 113482.63 |
| Total Medicare Standardized Payment Amount | 112430.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 5927 |
| Number Of Medicare Beneficiaries With Medical Services | 3188 |
| Total Medical Submitted Charge Amount | 523827 |
| Total Medical Medicare Allowed Amount | 144943.6 |
| Total Medical Medicare Payment Amount | 113482.63 |
| Total Medical Medicare Standardized Payment Amount | 112430.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 1306 |
| Number Of Beneficiaries Age 75 to 84 | 865 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 2198 |
| Number Of Male Beneficiaries | 990 |
| Number Of Non Hispanic White Beneficiaries | 3002 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 707 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3868 |