| National Provider Identifier [NPI]: | 1508856717 |
| Last Name Of The Provider | STANIETZKY |
| First Name Of The Provider | NIR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12951 SOUTH FWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770471923 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 4107 |
| Number Of Medicare Beneficiaries | 2927 |
| Total Submitted Charge Amount | 901347 |
| Total Medicare Allowed Amount | 147236.27 |
| Total Medicare Payment Amount | 109650.99 |
| Total Medicare Standardized Payment Amount | 109829.65 |
| 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 | 155 |
| Number Of Medical Services | 4107 |
| Number Of Medicare Beneficiaries With Medical Services | 2927 |
| Total Medical Submitted Charge Amount | 901347 |
| Total Medical Medicare Allowed Amount | 147236.27 |
| Total Medical Medicare Payment Amount | 109650.99 |
| Total Medical Medicare Standardized Payment Amount | 109829.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 516 |
| Number Of Beneficiaries Age 65 to 74 | 1170 |
| Number Of Beneficiaries Age 75 to 84 | 826 |
| Number Of Beneficiaries Age Greater 84 | 415 |
| Number Of Female Beneficiaries | 1657 |
| Number Of Male Beneficiaries | 1270 |
| Number Of Non Hispanic White Beneficiaries | 2050 |
| Number Of Black or African American Beneficiaries | 465 |
| Number Of AsianPacific Islander Beneficiaries | 60 |
| Number Of Hispanic Beneficiaries | 324 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2413 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 514 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3287 |