| National Provider Identifier [NPI]: | 1275814618 |
| Last Name Of The Provider | KHODADADIAN |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 E SUNRISE HWY |
| Street Address 2 Of The Provider | 208 |
| City Of The Provider | LINDENHURST |
| Zip Code Of The Provider | 117572539 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 3621 |
| Number Of Medicare Beneficiaries | 1104 |
| Total Submitted Charge Amount | 2745304.87 |
| Total Medicare Allowed Amount | 1422666.78 |
| Total Medicare Payment Amount | 1101060.48 |
| Total Medicare Standardized Payment Amount | 1078628.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1002 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 6716.1 |
| Total Drug Medicare AllowedAmount | 4108.76 |
| Total Drug Medicare PaymentAmount | 3183.8 |
| Total Drug Medicare Standardized Payment Amount | 3183.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2619 |
| Number Of Medicare Beneficiaries With Medical Services | 1104 |
| Total Medical Submitted Charge Amount | 2738588.77 |
| Total Medical Medicare Allowed Amount | 1418558.02 |
| Total Medical Medicare Payment Amount | 1097876.68 |
| Total Medical Medicare Standardized Payment Amount | 1075444.75 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 477 |
| Number Of Beneficiaries Age 75 to 84 | 362 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 589 |
| Number Of Male Beneficiaries | 515 |
| Number Of Non Hispanic White Beneficiaries | 968 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 970 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 48 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6731 |