| National Provider Identifier [NPI]: | 1003072950 |
| Last Name Of The Provider | BLUESTONE |
| First Name Of The Provider | AVRAHAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD,PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | STONY BROOK RADIOLOGY |
| Street Address 2 Of The Provider | HSC L4, ROOM 120 |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117948460 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 5584 |
| Number Of Medicare Beneficiaries | 3261 |
| Total Submitted Charge Amount | 1245104 |
| Total Medicare Allowed Amount | 230107.2 |
| Total Medicare Payment Amount | 176442.37 |
| Total Medicare Standardized Payment Amount | 160674.52 |
| 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 | 130 |
| Number Of Medical Services | 5584 |
| Number Of Medicare Beneficiaries With Medical Services | 3261 |
| Total Medical Submitted Charge Amount | 1245104 |
| Total Medical Medicare Allowed Amount | 230107.2 |
| Total Medical Medicare Payment Amount | 176442.37 |
| Total Medical Medicare Standardized Payment Amount | 160674.52 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 476 |
| Number Of Beneficiaries Age 65 to 74 | 994 |
| Number Of Beneficiaries Age 75 to 84 | 1066 |
| Number Of Beneficiaries Age Greater 84 | 725 |
| Number Of Female Beneficiaries | 1873 |
| Number Of Male Beneficiaries | 1388 |
| Number Of Non Hispanic White Beneficiaries | 2922 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 139 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2497 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 764 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.8849 |