| National Provider Identifier [NPI]: | 1740264308 |
| Last Name Of The Provider | ELSANT |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2021 AVE X |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 11235 |
| 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 | 120 |
| Number Of Services | 3219 |
| Number Of Medicare Beneficiaries | 1785 |
| Total Submitted Charge Amount | 376874.4 |
| Total Medicare Allowed Amount | 85053.07 |
| Total Medicare Payment Amount | 65298.56 |
| Total Medicare Standardized Payment Amount | 58979.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3219 |
| Number Of Medicare Beneficiaries With Medical Services | 1785 |
| Total Medical Submitted Charge Amount | 376874.4 |
| Total Medical Medicare Allowed Amount | 85053.07 |
| Total Medical Medicare Payment Amount | 65298.56 |
| Total Medical Medicare Standardized Payment Amount | 58979.34 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 218 |
| Number Of Beneficiaries Age 65 to 74 | 381 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 653 |
| Number Of Female Beneficiaries | 1086 |
| Number Of Male Beneficiaries | 699 |
| Number Of Non Hispanic White Beneficiaries | 1579 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | 68 |
| 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 | 1264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 521 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.094 |