| National Provider Identifier [NPI]: | 1730183302 |
| Last Name Of The Provider | SAMUEL |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 235 N BELLE MEAD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | E SETAUKET |
| Zip Code Of The Provider | 117333456 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 200505 |
| Number Of Medicare Beneficiaries | 1417 |
| Total Submitted Charge Amount | 6143074.02 |
| Total Medicare Allowed Amount | 2981694.08 |
| Total Medicare Payment Amount | 2349094.97 |
| Total Medicare Standardized Payment Amount | 2278693.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 91 |
| Number Of Drug Services | 178787 |
| Number Of Medicare Beneficiaries With Drug Services | 546 |
| Total Drug Submitted ChargeAmount | 3659117.84 |
| Total Drug Medicare AllowedAmount | 1982719.84 |
| Total Drug Medicare PaymentAmount | 1554148.73 |
| Total Drug Medicare Standardized Payment Amount | 1554148.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 21718 |
| Number Of Medicare Beneficiaries With Medical Services | 1416 |
| Total Medical Submitted Charge Amount | 2483956.18 |
| Total Medical Medicare Allowed Amount | 998974.24 |
| Total Medical Medicare Payment Amount | 794946.24 |
| Total Medical Medicare Standardized Payment Amount | 724544.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 496 |
| Number Of Beneficiaries Age Greater 84 | 241 |
| Number Of Female Beneficiaries | 818 |
| Number Of Male Beneficiaries | 599 |
| Number Of Non Hispanic White Beneficiaries | 1295 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 39 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2692 |