| National Provider Identifier [NPI]: | 1669445268 |
| Last Name Of The Provider | MARCANTONIO |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3601 W 13 MILE ROAD |
| Street Address 2 Of The Provider | DIAGNOSTIC RADIOLOGY |
| City Of The Provider | ROYAL OAK |
| Zip Code Of The Provider | 487036769 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 5463 |
| Number Of Medicare Beneficiaries | 3549 |
| Total Submitted Charge Amount | 152076 |
| Total Medicare Allowed Amount | 86066.94 |
| Total Medicare Payment Amount | 62845.83 |
| Total Medicare Standardized Payment Amount | 60789.42 |
| 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 | 123 |
| Number Of Medical Services | 5463 |
| Number Of Medicare Beneficiaries With Medical Services | 3549 |
| Total Medical Submitted Charge Amount | 152076 |
| Total Medical Medicare Allowed Amount | 86066.94 |
| Total Medical Medicare Payment Amount | 62845.83 |
| Total Medical Medicare Standardized Payment Amount | 60789.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 536 |
| Number Of Beneficiaries Age 65 to 74 | 1185 |
| Number Of Beneficiaries Age 75 to 84 | 1132 |
| Number Of Beneficiaries Age Greater 84 | 696 |
| Number Of Female Beneficiaries | 2153 |
| Number Of Male Beneficiaries | 1396 |
| Number Of Non Hispanic White Beneficiaries | 2816 |
| Number Of Black or African American Beneficiaries | 571 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2921 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 628 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9888 |