| National Provider Identifier [NPI]: | 1114960200 |
| Last Name Of The Provider | SIRAGUSA |
| First Name Of The Provider | ROY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | SUITE# 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 21205.5 |
| Number Of Medicare Beneficiaries | 3580 |
| Total Submitted Charge Amount | 1734156.16 |
| Total Medicare Allowed Amount | 566018.05 |
| Total Medicare Payment Amount | 445013.58 |
| Total Medicare Standardized Payment Amount | 458068.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 15773.5 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 22563.28 |
| Total Drug Medicare AllowedAmount | 4332.89 |
| Total Drug Medicare PaymentAmount | 3334.61 |
| Total Drug Medicare Standardized Payment Amount | 3334.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 225 |
| Number Of Medical Services | 5432 |
| Number Of Medicare Beneficiaries With Medical Services | 3580 |
| Total Medical Submitted Charge Amount | 1711592.88 |
| Total Medical Medicare Allowed Amount | 561685.16 |
| Total Medical Medicare Payment Amount | 441678.97 |
| Total Medical Medicare Standardized Payment Amount | 454734.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 506 |
| Number Of Beneficiaries Age 65 to 74 | 1542 |
| Number Of Beneficiaries Age 75 to 84 | 1059 |
| Number Of Beneficiaries Age Greater 84 | 473 |
| Number Of Female Beneficiaries | 2345 |
| Number Of Male Beneficiaries | 1235 |
| Number Of Non Hispanic White Beneficiaries | 3116 |
| Number Of Black or African American Beneficiaries | 289 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2981 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 599 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.341 |