| National Provider Identifier [NPI]: | 1356451157 |
| Last Name Of The Provider | BRANCACCIO |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1333 ROANOKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERHEAD |
| Zip Code Of The Provider | 11901 |
| 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 | 141 |
| Number Of Services | 5222 |
| Number Of Medicare Beneficiaries | 3026 |
| Total Submitted Charge Amount | 576304.82 |
| Total Medicare Allowed Amount | 149838.78 |
| Total Medicare Payment Amount | 116348.95 |
| Total Medicare Standardized Payment Amount | 103135.79 |
| 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 | 141 |
| Number Of Medical Services | 5222 |
| Number Of Medicare Beneficiaries With Medical Services | 3026 |
| Total Medical Submitted Charge Amount | 576304.82 |
| Total Medical Medicare Allowed Amount | 149838.78 |
| Total Medical Medicare Payment Amount | 116348.95 |
| Total Medical Medicare Standardized Payment Amount | 103135.79 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 256 |
| Number Of Beneficiaries Age 65 to 74 | 1078 |
| Number Of Beneficiaries Age 75 to 84 | 947 |
| Number Of Beneficiaries Age Greater 84 | 745 |
| Number Of Female Beneficiaries | 1775 |
| Number Of Male Beneficiaries | 1251 |
| Number Of Non Hispanic White Beneficiaries | 2710 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2510 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 516 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6786 |