| National Provider Identifier [NPI]: | 1033214077 |
| Last Name Of The Provider | SISTO |
| First Name Of The Provider | JOAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 155 BORTHWICK AVE |
| Street Address 2 Of The Provider | SUITE 201 WEST |
| City Of The Provider | PORTSMOUTH |
| Zip Code Of The Provider | 038017156 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 9665 |
| Number Of Medicare Beneficiaries | 1619 |
| Total Submitted Charge Amount | 639189.72 |
| Total Medicare Allowed Amount | 450296.48 |
| Total Medicare Payment Amount | 330276.77 |
| Total Medicare Standardized Payment Amount | 316114.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 6197.55 |
| Total Drug Medicare AllowedAmount | 5345.08 |
| Total Drug Medicare PaymentAmount | 4190.6 |
| Total Drug Medicare Standardized Payment Amount | 4190.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 9623 |
| Number Of Medicare Beneficiaries With Medical Services | 1619 |
| Total Medical Submitted Charge Amount | 632992.17 |
| Total Medical Medicare Allowed Amount | 444951.4 |
| Total Medical Medicare Payment Amount | 326086.17 |
| Total Medical Medicare Standardized Payment Amount | 311923.91 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 853 |
| Number Of Beneficiaries Age 75 to 84 | 570 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 1083 |
| Number Of Male Beneficiaries | 536 |
| Number Of Non Hispanic White Beneficiaries | 1581 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1571 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8145 |