| National Provider Identifier [NPI]: | 1386731784 |
| Last Name Of The Provider | INGENITO |
| First Name Of The Provider | EILEEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 159 INDIAN HEAD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COMMACK |
| Zip Code Of The Provider | 117252205 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 1310 |
| Number Of Medicare Beneficiaries | 461 |
| Total Submitted Charge Amount | 355747.95 |
| Total Medicare Allowed Amount | 88539.52 |
| Total Medicare Payment Amount | 64630.04 |
| Total Medicare Standardized Payment Amount | 65809.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1028 |
| Total Drug Medicare AllowedAmount | 944.89 |
| Total Drug Medicare PaymentAmount | 925.92 |
| Total Drug Medicare Standardized Payment Amount | 925.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 1256 |
| Number Of Medicare Beneficiaries With Medical Services | 461 |
| Total Medical Submitted Charge Amount | 354719.95 |
| Total Medical Medicare Allowed Amount | 87594.63 |
| Total Medical Medicare Payment Amount | 63704.12 |
| Total Medical Medicare Standardized Payment Amount | 64883.69 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 394 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 314 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 378 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 0 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 461 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 33 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 12 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.265 |