| National Provider Identifier [NPI]: | 1134127178 |
| Last Name Of The Provider | DELAURENTIS |
| First Name Of The Provider | MARK |
| 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 | 100 CARNIE BLVD |
| Street Address 2 Of The Provider | SUITE B-5 |
| City Of The Provider | VOORHEES |
| Zip Code Of The Provider | 080434512 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 261 |
| Number Of Services | 5544.7 |
| Number Of Medicare Beneficiaries | 1835 |
| Total Submitted Charge Amount | 736523 |
| Total Medicare Allowed Amount | 195867.69 |
| Total Medicare Payment Amount | 154109.01 |
| Total Medicare Standardized Payment Amount | 144359.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2500.7 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2862 |
| Total Drug Medicare AllowedAmount | 555.66 |
| Total Drug Medicare PaymentAmount | 435.63 |
| Total Drug Medicare Standardized Payment Amount | 435.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 258 |
| Number Of Medical Services | 3044 |
| Number Of Medicare Beneficiaries With Medical Services | 1835 |
| Total Medical Submitted Charge Amount | 733661 |
| Total Medical Medicare Allowed Amount | 195312.03 |
| Total Medical Medicare Payment Amount | 153673.38 |
| Total Medical Medicare Standardized Payment Amount | 143923.67 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 248 |
| Number Of Beneficiaries Age 65 to 74 | 604 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 408 |
| Number Of Female Beneficiaries | 1129 |
| Number Of Male Beneficiaries | 706 |
| Number Of Non Hispanic White Beneficiaries | 1533 |
| Number Of Black or African American Beneficiaries | 185 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1558 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 277 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9528 |