| National Provider Identifier [NPI]: | 1700822566 |
| Last Name Of The Provider | MASON |
| First Name Of The Provider | MARYANNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | UNIVERSITY HOSPITAL, L4 |
| Street Address 2 Of The Provider | |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117940001 |
| 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 | 4842 |
| Number Of Medicare Beneficiaries | 3205 |
| Total Submitted Charge Amount | 654939 |
| Total Medicare Allowed Amount | 129489.84 |
| Total Medicare Payment Amount | 97838.55 |
| Total Medicare Standardized Payment Amount | 88345.92 |
| 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 | 105 |
| Number Of Medical Services | 4842 |
| Number Of Medicare Beneficiaries With Medical Services | 3205 |
| Total Medical Submitted Charge Amount | 654939 |
| Total Medical Medicare Allowed Amount | 129489.84 |
| Total Medical Medicare Payment Amount | 97838.55 |
| Total Medical Medicare Standardized Payment Amount | 88345.92 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 490 |
| Number Of Beneficiaries Age 65 to 74 | 1022 |
| Number Of Beneficiaries Age 75 to 84 | 999 |
| Number Of Beneficiaries Age Greater 84 | 694 |
| Number Of Female Beneficiaries | 1662 |
| Number Of Male Beneficiaries | 1543 |
| Number Of Non Hispanic White Beneficiaries | 2862 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 860 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1599 |