| National Provider Identifier [NPI]: | 1205969250 |
| Last Name Of The Provider | DAGNOLO |
| First Name Of The Provider | ALESSANDRO |
| 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 | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | ROOM M 335 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 90048 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 4184 |
| Number Of Medicare Beneficiaries | 3481 |
| Total Submitted Charge Amount | 1668461 |
| Total Medicare Allowed Amount | 247340.12 |
| Total Medicare Payment Amount | 192172.05 |
| Total Medicare Standardized Payment Amount | 182332.64 |
| 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 | 67 |
| Number Of Medical Services | 4184 |
| Number Of Medicare Beneficiaries With Medical Services | 3481 |
| Total Medical Submitted Charge Amount | 1668461 |
| Total Medical Medicare Allowed Amount | 247340.12 |
| Total Medical Medicare Payment Amount | 192172.05 |
| Total Medical Medicare Standardized Payment Amount | 182332.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 328 |
| Number Of Beneficiaries Age 65 to 74 | 1622 |
| Number Of Beneficiaries Age 75 to 84 | 1069 |
| Number Of Beneficiaries Age Greater 84 | 462 |
| Number Of Female Beneficiaries | 2308 |
| Number Of Male Beneficiaries | 1173 |
| Number Of Non Hispanic White Beneficiaries | 2473 |
| Number Of Black or African American Beneficiaries | 382 |
| Number Of AsianPacific Islander Beneficiaries | 244 |
| Number Of Hispanic Beneficiaries | 267 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1136 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9451 |