| National Provider Identifier [NPI]: | 1912900176 |
| Last Name Of The Provider | LEBLANG |
| First Name Of The Provider | SUZANNE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3848 FAU BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BOCA RATON |
| Zip Code Of The Provider | 334316437 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 6485 |
| Number Of Medicare Beneficiaries | 1307 |
| Total Submitted Charge Amount | 2113787 |
| Total Medicare Allowed Amount | 310870.27 |
| Total Medicare Payment Amount | 240343.85 |
| Total Medicare Standardized Payment Amount | 235066.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4709 |
| Number Of Medicare Beneficiaries With Drug Services | 232 |
| Total Drug Submitted ChargeAmount | 53640 |
| Total Drug Medicare AllowedAmount | 7627.43 |
| Total Drug Medicare PaymentAmount | 5979.75 |
| Total Drug Medicare Standardized Payment Amount | 5979.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 1776 |
| Number Of Medicare Beneficiaries With Medical Services | 1306 |
| Total Medical Submitted Charge Amount | 2060147 |
| Total Medical Medicare Allowed Amount | 303242.84 |
| Total Medical Medicare Payment Amount | 234364.1 |
| Total Medical Medicare Standardized Payment Amount | 229087.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 515 |
| Number Of Beneficiaries Age 75 to 84 | 436 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 762 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 1231 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2832 |