| National Provider Identifier [NPI]: | 1437180619 |
| Last Name Of The Provider | KOSHY |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 45 PINE GROVE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KINGSTON |
| Zip Code Of The Provider | 124015407 |
| 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 | 139 |
| Number Of Services | 9947 |
| Number Of Medicare Beneficiaries | 2296 |
| Total Submitted Charge Amount | 396023.3 |
| Total Medicare Allowed Amount | 152634.51 |
| Total Medicare Payment Amount | 116286.8 |
| Total Medicare Standardized Payment Amount | 113426.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 5877 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1763.1 |
| Total Drug Medicare AllowedAmount | 993.27 |
| Total Drug Medicare PaymentAmount | 778.69 |
| Total Drug Medicare Standardized Payment Amount | 778.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 4070 |
| Number Of Medicare Beneficiaries With Medical Services | 2296 |
| Total Medical Submitted Charge Amount | 394260.2 |
| Total Medical Medicare Allowed Amount | 151641.24 |
| Total Medical Medicare Payment Amount | 115508.11 |
| Total Medical Medicare Standardized Payment Amount | 112648.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 439 |
| Number Of Beneficiaries Age 65 to 74 | 733 |
| Number Of Beneficiaries Age 75 to 84 | 644 |
| Number Of Beneficiaries Age Greater 84 | 480 |
| Number Of Female Beneficiaries | 1258 |
| Number Of Male Beneficiaries | 1038 |
| Number Of Non Hispanic White Beneficiaries | 2091 |
| Number Of Black or African American Beneficiaries | 102 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1506 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 790 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6253 |