| National Provider Identifier [NPI]: | 1235275496 |
| Last Name Of The Provider | ALTIERI |
| First Name Of The Provider | DOMINIC |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 NESCONSET HWY BLDG 15A |
| Street Address 2 Of The Provider | |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117902554 |
| 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 | 127 |
| Number Of Services | 6831 |
| Number Of Medicare Beneficiaries | 3152 |
| Total Submitted Charge Amount | 829047.9 |
| Total Medicare Allowed Amount | 185871.35 |
| Total Medicare Payment Amount | 142212.39 |
| Total Medicare Standardized Payment Amount | 128545.3 |
| 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 | 127 |
| Number Of Medical Services | 6831 |
| Number Of Medicare Beneficiaries With Medical Services | 3152 |
| Total Medical Submitted Charge Amount | 829047.9 |
| Total Medical Medicare Allowed Amount | 185871.35 |
| Total Medical Medicare Payment Amount | 142212.39 |
| Total Medical Medicare Standardized Payment Amount | 128545.3 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 379 |
| Number Of Beneficiaries Age 65 to 74 | 688 |
| Number Of Beneficiaries Age 75 to 84 | 967 |
| Number Of Beneficiaries Age Greater 84 | 1118 |
| Number Of Female Beneficiaries | 1918 |
| Number Of Male Beneficiaries | 1234 |
| Number Of Non Hispanic White Beneficiaries | 2817 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | 99 |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2265 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 887 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9985 |