| National Provider Identifier [NPI]: | 1003886946 |
| Last Name Of The Provider | MALTIN |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 E SUNRISE HWY |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | LINDENHURST |
| Zip Code Of The Provider | 117572598 |
| 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 | 105 |
| Number Of Services | 6529.5 |
| Number Of Medicare Beneficiaries | 1190 |
| Total Submitted Charge Amount | 1318186.5 |
| Total Medicare Allowed Amount | 301388.62 |
| Total Medicare Payment Amount | 231374.25 |
| Total Medicare Standardized Payment Amount | 198778.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4907.5 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 29735 |
| Total Drug Medicare AllowedAmount | 4686.85 |
| Total Drug Medicare PaymentAmount | 3641.8 |
| Total Drug Medicare Standardized Payment Amount | 3641.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 1622 |
| Number Of Medicare Beneficiaries With Medical Services | 1190 |
| Total Medical Submitted Charge Amount | 1288451.5 |
| Total Medical Medicare Allowed Amount | 296701.77 |
| Total Medical Medicare Payment Amount | 227732.45 |
| Total Medical Medicare Standardized Payment Amount | 195136.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 551 |
| Number Of Beneficiaries Age 75 to 84 | 371 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 744 |
| Number Of Male Beneficiaries | 446 |
| Number Of Non Hispanic White Beneficiaries | 1037 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1080 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.131 |