| National Provider Identifier [NPI]: | 1306082326 |
| Last Name Of The Provider | ALIAN |
| First Name Of The Provider | ANDRUS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | STONY BROOK UNIVERSITY HOSPITAL |
| Street Address 2 Of The Provider | HSC, LEVEL 4, ROOM 080 |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117948350 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 819 |
| Number Of Medicare Beneficiaries | 693 |
| Total Submitted Charge Amount | 582535.92 |
| Total Medicare Allowed Amount | 142426.82 |
| Total Medicare Payment Amount | 109186.57 |
| Total Medicare Standardized Payment Amount | 98185.52 |
| 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 | 42 |
| Number Of Medical Services | 819 |
| Number Of Medicare Beneficiaries With Medical Services | 693 |
| Total Medical Submitted Charge Amount | 582535.92 |
| Total Medical Medicare Allowed Amount | 142426.82 |
| Total Medical Medicare Payment Amount | 109186.57 |
| Total Medical Medicare Standardized Payment Amount | 98185.52 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 387 |
| Number Of Male Beneficiaries | 306 |
| Number Of Non Hispanic White Beneficiaries | 556 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 320 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.2234 |