| National Provider Identifier [NPI]: | 1043293962 |
| Last Name Of The Provider | SUNTAY |
| First Name Of The Provider | WILFREDO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7901 SCHATZ POINTE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454593856 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 5492 |
| Number Of Medicare Beneficiaries | 3872 |
| Total Submitted Charge Amount | 415358 |
| Total Medicare Allowed Amount | 106553.7 |
| Total Medicare Payment Amount | 81783.58 |
| Total Medicare Standardized Payment Amount | 83970.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 5492 |
| Number Of Medicare Beneficiaries With Medical Services | 3872 |
| Total Medical Submitted Charge Amount | 415358 |
| Total Medical Medicare Allowed Amount | 106553.7 |
| Total Medical Medicare Payment Amount | 81783.58 |
| Total Medical Medicare Standardized Payment Amount | 83970.46 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 754 |
| Number Of Beneficiaries Age 65 to 74 | 1346 |
| Number Of Beneficiaries Age 75 to 84 | 1084 |
| Number Of Beneficiaries Age Greater 84 | 688 |
| Number Of Female Beneficiaries | 2416 |
| Number Of Male Beneficiaries | 1456 |
| Number Of Non Hispanic White Beneficiaries | 3521 |
| Number Of Black or African American Beneficiaries | 249 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2903 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 969 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6949 |