| National Provider Identifier [NPI]: | 1689688863 |
| Last Name Of The Provider | TOMCZAK |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 990 STEWART AVE |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | GARDEN CITY |
| Zip Code Of The Provider | 115304822 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4185 |
| Number Of Medicare Beneficiaries | 1384 |
| Total Submitted Charge Amount | 630650.25 |
| Total Medicare Allowed Amount | 289978.77 |
| Total Medicare Payment Amount | 222088.02 |
| Total Medicare Standardized Payment Amount | 187132.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1980 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 830.25 |
| Total Drug Medicare AllowedAmount | 545.28 |
| Total Drug Medicare PaymentAmount | 400.34 |
| Total Drug Medicare Standardized Payment Amount | 400.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2205 |
| Number Of Medicare Beneficiaries With Medical Services | 1384 |
| Total Medical Submitted Charge Amount | 629820 |
| Total Medical Medicare Allowed Amount | 289433.49 |
| Total Medical Medicare Payment Amount | 221687.68 |
| Total Medical Medicare Standardized Payment Amount | 186732.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 744 |
| Number Of Beneficiaries Age 75 to 84 | 406 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 1090 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 1172 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1311 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0762 |