| National Provider Identifier [NPI]: | 1801904180 |
| Last Name Of The Provider | ROSENTHAL |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 115 CASS AVE |
| Street Address 2 Of The Provider | HOSPITAL BASED LANDMARK MEDICAL CENTER |
| City Of The Provider | WOONSOCKET |
| Zip Code Of The Provider | 02895 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 201 |
| Number Of Services | 8314 |
| Number Of Medicare Beneficiaries | 3212 |
| Total Submitted Charge Amount | 634048.7 |
| Total Medicare Allowed Amount | 267447.75 |
| Total Medicare Payment Amount | 206631.54 |
| Total Medicare Standardized Payment Amount | 200083.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2071 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 3842 |
| Total Drug Medicare AllowedAmount | 376.91 |
| Total Drug Medicare PaymentAmount | 295.47 |
| Total Drug Medicare Standardized Payment Amount | 295.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 6243 |
| Number Of Medicare Beneficiaries With Medical Services | 3212 |
| Total Medical Submitted Charge Amount | 630206.7 |
| Total Medical Medicare Allowed Amount | 267070.84 |
| Total Medical Medicare Payment Amount | 206336.07 |
| Total Medical Medicare Standardized Payment Amount | 199788.23 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 818 |
| Number Of Beneficiaries Age 65 to 74 | 1113 |
| Number Of Beneficiaries Age 75 to 84 | 744 |
| Number Of Beneficiaries Age Greater 84 | 537 |
| Number Of Female Beneficiaries | 2203 |
| Number Of Male Beneficiaries | 1009 |
| Number Of Non Hispanic White Beneficiaries | 2915 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 159 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1183 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4903 |