| National Provider Identifier [NPI]: | 1750474524 |
| Last Name Of The Provider | PANICHELLA |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 124 MAIN ST |
| Street Address 2 Of The Provider | STE 9 |
| City Of The Provider | HUNTINGTON |
| Zip Code Of The Provider | 11743 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 7815 |
| Number Of Medicare Beneficiaries | 1397 |
| Total Submitted Charge Amount | 2210198.38 |
| Total Medicare Allowed Amount | 653773.66 |
| Total Medicare Payment Amount | 492757.86 |
| Total Medicare Standardized Payment Amount | 423171.75 |
| 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 | 30 |
| Number Of Medical Services | 7815 |
| Number Of Medicare Beneficiaries With Medical Services | 1397 |
| Total Medical Submitted Charge Amount | 2210198.38 |
| Total Medical Medicare Allowed Amount | 653773.66 |
| Total Medical Medicare Payment Amount | 492757.86 |
| Total Medical Medicare Standardized Payment Amount | 423171.75 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 529 |
| Number Of Beneficiaries Age 75 to 84 | 562 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 832 |
| Number Of Male Beneficiaries | 565 |
| Number Of Non Hispanic White Beneficiaries | 1318 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.065 |