| National Provider Identifier [NPI]: | 1063422087 |
| Last Name Of The Provider | BRUZZESE |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 TOLL GATE RD |
| Street Address 2 Of The Provider | STE 101A |
| City Of The Provider | WARWICK |
| Zip Code Of The Provider | 028864416 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 20552 |
| Number Of Medicare Beneficiaries | 2947 |
| Total Submitted Charge Amount | 1225771.55 |
| Total Medicare Allowed Amount | 417613.08 |
| Total Medicare Payment Amount | 322019.99 |
| Total Medicare Standardized Payment Amount | 310870.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 15241 |
| Number Of Medicare Beneficiaries With Drug Services | 143 |
| Total Drug Submitted ChargeAmount | 22850.12 |
| Total Drug Medicare AllowedAmount | 3153.53 |
| Total Drug Medicare PaymentAmount | 2455.41 |
| Total Drug Medicare Standardized Payment Amount | 2455.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 5311 |
| Number Of Medicare Beneficiaries With Medical Services | 2947 |
| Total Medical Submitted Charge Amount | 1202921.43 |
| Total Medical Medicare Allowed Amount | 414459.55 |
| Total Medical Medicare Payment Amount | 319564.58 |
| Total Medical Medicare Standardized Payment Amount | 308415.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 690 |
| Number Of Beneficiaries Age 65 to 74 | 1109 |
| Number Of Beneficiaries Age 75 to 84 | 687 |
| Number Of Beneficiaries Age Greater 84 | 461 |
| Number Of Female Beneficiaries | 1887 |
| Number Of Male Beneficiaries | 1060 |
| Number Of Non Hispanic White Beneficiaries | 2641 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 152 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2044 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 903 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4084 |