| National Provider Identifier [NPI]: | 1871563833 |
| Last Name Of The Provider | STICCO |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 E SUNRISE HWY |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | LINDENHURST |
| Zip Code Of The Provider | 117572598 |
| 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 | 122 |
| Number Of Services | 90057 |
| Number Of Medicare Beneficiaries | 2912 |
| Total Submitted Charge Amount | 2379646.31 |
| Total Medicare Allowed Amount | 872852.17 |
| Total Medicare Payment Amount | 665981.79 |
| Total Medicare Standardized Payment Amount | 574733.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 85542 |
| Number Of Medicare Beneficiaries With Drug Services | 998 |
| Total Drug Submitted ChargeAmount | 31847.49 |
| Total Drug Medicare AllowedAmount | 17684.46 |
| Total Drug Medicare PaymentAmount | 13493.9 |
| Total Drug Medicare Standardized Payment Amount | 13493.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 4515 |
| Number Of Medicare Beneficiaries With Medical Services | 2904 |
| Total Medical Submitted Charge Amount | 2347798.82 |
| Total Medical Medicare Allowed Amount | 855167.71 |
| Total Medical Medicare Payment Amount | 652487.89 |
| Total Medical Medicare Standardized Payment Amount | 561239.43 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 371 |
| Number Of Beneficiaries Age 65 to 74 | 1237 |
| Number Of Beneficiaries Age 75 to 84 | 919 |
| Number Of Beneficiaries Age Greater 84 | 385 |
| Number Of Female Beneficiaries | 1581 |
| Number Of Male Beneficiaries | 1331 |
| Number Of Non Hispanic White Beneficiaries | 2574 |
| Number Of Black or African American Beneficiaries | 113 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2543 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 369 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3946 |