| National Provider Identifier [NPI]: | 1457436883 |
| Last Name Of The Provider | SUTILLA |
| First Name Of The Provider | CONSTANCE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 255 W LANCASTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAOLI |
| Zip Code Of The Provider | 193011763 |
| 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 | 104 |
| Number Of Services | 5133 |
| Number Of Medicare Beneficiaries | 2832 |
| Total Submitted Charge Amount | 528005 |
| Total Medicare Allowed Amount | 125048.98 |
| Total Medicare Payment Amount | 101941.3 |
| Total Medicare Standardized Payment Amount | 98142.74 |
| 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 | 104 |
| Number Of Medical Services | 5133 |
| Number Of Medicare Beneficiaries With Medical Services | 2832 |
| Total Medical Submitted Charge Amount | 528005 |
| Total Medical Medicare Allowed Amount | 125048.98 |
| Total Medical Medicare Payment Amount | 101941.3 |
| Total Medical Medicare Standardized Payment Amount | 98142.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 1137 |
| Number Of Beneficiaries Age 75 to 84 | 852 |
| Number Of Beneficiaries Age Greater 84 | 536 |
| Number Of Female Beneficiaries | 2063 |
| Number Of Male Beneficiaries | 769 |
| Number Of Non Hispanic White Beneficiaries | 1988 |
| Number Of Black or African American Beneficiaries | 747 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 443 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6879 |