| National Provider Identifier [NPI]: | 1033352448 |
| Last Name Of The Provider | SAKELLARIOS |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| 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 | MEDICAL STAFF OFFICE T14 |
| 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 | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 2287 |
| Number Of Medicare Beneficiaries | 540 |
| Total Submitted Charge Amount | 285388 |
| Total Medicare Allowed Amount | 108208.52 |
| Total Medicare Payment Amount | 86214.4 |
| Total Medicare Standardized Payment Amount | 77846.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 21530 |
| Total Drug Medicare AllowedAmount | 8488.69 |
| Total Drug Medicare PaymentAmount | 8310.65 |
| Total Drug Medicare Standardized Payment Amount | 8310.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2161 |
| Number Of Medicare Beneficiaries With Medical Services | 540 |
| Total Medical Submitted Charge Amount | 263858 |
| Total Medical Medicare Allowed Amount | 99719.83 |
| Total Medical Medicare Payment Amount | 77903.75 |
| Total Medical Medicare Standardized Payment Amount | 69536.08 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 506 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0728 |