| National Provider Identifier [NPI]: | 1518130442 |
| Last Name Of The Provider | SU |
| First Name Of The Provider | HSIU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | STONY BROOK UNIVERSITY HOSPITAL |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117948460 |
| 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 | 144 |
| Number Of Services | 7627 |
| Number Of Medicare Beneficiaries | 4424 |
| Total Submitted Charge Amount | 1069275.45 |
| Total Medicare Allowed Amount | 251927.52 |
| Total Medicare Payment Amount | 190040.97 |
| Total Medicare Standardized Payment Amount | 177253.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 515.45 |
| Total Drug Medicare AllowedAmount | 346.8 |
| Total Drug Medicare PaymentAmount | 271.89 |
| Total Drug Medicare Standardized Payment Amount | 271.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 7356 |
| Number Of Medicare Beneficiaries With Medical Services | 4424 |
| Total Medical Submitted Charge Amount | 1068760 |
| Total Medical Medicare Allowed Amount | 251580.72 |
| Total Medical Medicare Payment Amount | 189769.08 |
| Total Medical Medicare Standardized Payment Amount | 176981.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 1594 |
| Number Of Beneficiaries Age 75 to 84 | 1503 |
| Number Of Beneficiaries Age Greater 84 | 912 |
| Number Of Female Beneficiaries | 2486 |
| Number Of Male Beneficiaries | 1938 |
| Number Of Non Hispanic White Beneficiaries | 3952 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 83 |
| Number Of Hispanic Beneficiaries | 134 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 523 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6897 |