| National Provider Identifier [NPI]: | 1427089127 |
| Last Name Of The Provider | BENITEZ |
| First Name Of The Provider | CARLOS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 10TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100191147 |
| 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 | 81 |
| Number Of Services | 1933 |
| Number Of Medicare Beneficiaries | 1104 |
| Total Submitted Charge Amount | 631758.08 |
| Total Medicare Allowed Amount | 169349.94 |
| Total Medicare Payment Amount | 129041.41 |
| Total Medicare Standardized Payment Amount | 113322.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 408 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2130.08 |
| Total Drug Medicare AllowedAmount | 559.87 |
| Total Drug Medicare PaymentAmount | 369.57 |
| Total Drug Medicare Standardized Payment Amount | 369.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 1525 |
| Number Of Medicare Beneficiaries With Medical Services | 1104 |
| Total Medical Submitted Charge Amount | 629628 |
| Total Medical Medicare Allowed Amount | 168790.07 |
| Total Medical Medicare Payment Amount | 128671.84 |
| Total Medical Medicare Standardized Payment Amount | 112952.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 454 |
| Number Of Beneficiaries Age 75 to 84 | 302 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 644 |
| Number Of Male Beneficiaries | 460 |
| Number Of Non Hispanic White Beneficiaries | 646 |
| Number Of Black or African American Beneficiaries | 202 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 203 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 406 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5021 |