| National Provider Identifier [NPI]: | 1679579502 |
| Last Name Of The Provider | DOGANIERO |
| First Name Of The Provider | ENRICO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 32-36 CENTRAL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WELLSBORO |
| Zip Code Of The Provider | 169011840 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 8356 |
| Number Of Medicare Beneficiaries | 2809 |
| Total Submitted Charge Amount | 858332.66 |
| Total Medicare Allowed Amount | 241620.88 |
| Total Medicare Payment Amount | 176730.66 |
| Total Medicare Standardized Payment Amount | 182101.75 |
| 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 | 163 |
| Number Of Medical Services | 8356 |
| Number Of Medicare Beneficiaries With Medical Services | 2809 |
| Total Medical Submitted Charge Amount | 858332.66 |
| Total Medical Medicare Allowed Amount | 241620.88 |
| Total Medical Medicare Payment Amount | 176730.66 |
| Total Medical Medicare Standardized Payment Amount | 182101.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 518 |
| Number Of Beneficiaries Age 65 to 74 | 1007 |
| Number Of Beneficiaries Age 75 to 84 | 831 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 1810 |
| Number Of Male Beneficiaries | 999 |
| Number Of Non Hispanic White Beneficiaries | 2765 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2024 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 785 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1873 |