| National Provider Identifier [NPI]: | 1518129030 |
| Last Name Of The Provider | VERZOSA |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 GUSTAVE L. LEVY PLACE |
| Street Address 2 Of The Provider | BOX 1194 |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100296574 |
| 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 | 68 |
| Number Of Services | 13502 |
| Number Of Medicare Beneficiaries | 2293 |
| Total Submitted Charge Amount | 460530.27 |
| Total Medicare Allowed Amount | 138070.6 |
| Total Medicare Payment Amount | 104196.08 |
| Total Medicare Standardized Payment Amount | 96286.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10673 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 10761.27 |
| Total Drug Medicare AllowedAmount | 1896.09 |
| Total Drug Medicare PaymentAmount | 1481.7 |
| Total Drug Medicare Standardized Payment Amount | 1481.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 2829 |
| Number Of Medicare Beneficiaries With Medical Services | 2292 |
| Total Medical Submitted Charge Amount | 449769 |
| Total Medical Medicare Allowed Amount | 136174.51 |
| Total Medical Medicare Payment Amount | 102714.38 |
| Total Medical Medicare Standardized Payment Amount | 94804.75 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 346 |
| Number Of Beneficiaries Age 65 to 74 | 833 |
| Number Of Beneficiaries Age 75 to 84 | 719 |
| Number Of Beneficiaries Age Greater 84 | 395 |
| Number Of Female Beneficiaries | 1195 |
| Number Of Male Beneficiaries | 1098 |
| Number Of Non Hispanic White Beneficiaries | 1676 |
| Number Of Black or African American Beneficiaries | 235 |
| Number Of AsianPacific Islander Beneficiaries | 106 |
| Number Of Hispanic Beneficiaries | 226 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 822 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3152 |