| National Provider Identifier [NPI]: | 1760443519 |
| Last Name Of The Provider | TILAK |
| First Name Of The Provider | SAMIR |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 748 KINGS HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODBURY |
| Zip Code Of The Provider | 080963157 |
| 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 | 182 |
| Number Of Services | 14645.3 |
| Number Of Medicare Beneficiaries | 2804 |
| Total Submitted Charge Amount | 1730049 |
| Total Medicare Allowed Amount | 452066.32 |
| Total Medicare Payment Amount | 355709.19 |
| Total Medicare Standardized Payment Amount | 334616.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 10274.3 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 29385 |
| Total Drug Medicare AllowedAmount | 4375.65 |
| Total Drug Medicare PaymentAmount | 3396.63 |
| Total Drug Medicare Standardized Payment Amount | 3396.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 4371 |
| Number Of Medicare Beneficiaries With Medical Services | 2804 |
| Total Medical Submitted Charge Amount | 1700664 |
| Total Medical Medicare Allowed Amount | 447690.67 |
| Total Medical Medicare Payment Amount | 352312.56 |
| Total Medical Medicare Standardized Payment Amount | 331219.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 435 |
| Number Of Beneficiaries Age 65 to 74 | 1154 |
| Number Of Beneficiaries Age 75 to 84 | 802 |
| Number Of Beneficiaries Age Greater 84 | 413 |
| Number Of Female Beneficiaries | 1837 |
| Number Of Male Beneficiaries | 967 |
| Number Of Non Hispanic White Beneficiaries | 2417 |
| Number Of Black or African American Beneficiaries | 255 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2367 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 437 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3972 |