| National Provider Identifier [NPI]: | 1801863295 |
| Last Name Of The Provider | STAPEN |
| First Name Of The Provider | RICHARD |
| 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 | 4160 MERRICK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASSAPEQUA |
| Zip Code Of The Provider | 117586000 |
| 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 | 65 |
| Number Of Services | 1659 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 58655.73 |
| Total Medicare Allowed Amount | 52198.75 |
| Total Medicare Payment Amount | 41972.53 |
| Total Medicare Standardized Payment Amount | 35992.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1200 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1500 |
| Total Drug Medicare AllowedAmount | 211.6 |
| Total Drug Medicare PaymentAmount | 165.88 |
| Total Drug Medicare Standardized Payment Amount | 165.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 459 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 57155.73 |
| Total Medical Medicare Allowed Amount | 51987.15 |
| Total Medical Medicare Payment Amount | 41806.65 |
| Total Medical Medicare Standardized Payment Amount | 35826.29 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 130 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 257 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 253 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1582 |