| National Provider Identifier [NPI]: | 1235151572 |
| Last Name Of The Provider | IANNOTTI |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 48 ROUTE 25A |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | SMITHTOWN |
| Zip Code Of The Provider | 117871431 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 1393 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 342782.01 |
| Total Medicare Allowed Amount | 125061.01 |
| Total Medicare Payment Amount | 93894.43 |
| Total Medicare Standardized Payment Amount | 82083.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 230 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 23817.62 |
| Total Drug Medicare AllowedAmount | 10521.09 |
| Total Drug Medicare PaymentAmount | 8148.55 |
| Total Drug Medicare Standardized Payment Amount | 8148.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 1163 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 318964.39 |
| Total Medical Medicare Allowed Amount | 114539.92 |
| Total Medical Medicare Payment Amount | 85745.88 |
| Total Medical Medicare Standardized Payment Amount | 73935.36 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0778 |