| National Provider Identifier [NPI]: | 1508897851 |
| Last Name Of The Provider | COLE |
| First Name Of The Provider | DOUGLAS |
| 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 | 375 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 12 |
| City Of The Provider | BAY SHORE |
| Zip Code Of The Provider | 117068418 |
| 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 | 158 |
| Number Of Services | 10485 |
| Number Of Medicare Beneficiaries | 1792 |
| Total Submitted Charge Amount | 912599.73 |
| Total Medicare Allowed Amount | 460959.03 |
| Total Medicare Payment Amount | 361200.14 |
| Total Medicare Standardized Payment Amount | 323010.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7484 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 16071.1 |
| Total Drug Medicare AllowedAmount | 1532.57 |
| Total Drug Medicare PaymentAmount | 1201.64 |
| Total Drug Medicare Standardized Payment Amount | 1201.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 154 |
| Number Of Medical Services | 3001 |
| Number Of Medicare Beneficiaries With Medical Services | 1787 |
| Total Medical Submitted Charge Amount | 896528.63 |
| Total Medical Medicare Allowed Amount | 459426.46 |
| Total Medical Medicare Payment Amount | 359998.5 |
| Total Medical Medicare Standardized Payment Amount | 321808.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 790 |
| Number Of Beneficiaries Age 75 to 84 | 586 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 1185 |
| Number Of Male Beneficiaries | 607 |
| Number Of Non Hispanic White Beneficiaries | 1495 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1546 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.263 |