| National Provider Identifier [NPI]: | 1144416975 |
| Last Name Of The Provider | RZADKOWOLSKY-RAOLI |
| First Name Of The Provider | ILAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4802 10TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112192916 |
| 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 | 203 |
| Number Of Services | 3961 |
| Number Of Medicare Beneficiaries | 2038 |
| Total Submitted Charge Amount | 674886 |
| Total Medicare Allowed Amount | 117121.76 |
| Total Medicare Payment Amount | 90433.25 |
| Total Medicare Standardized Payment Amount | 85003.9 |
| 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 | 203 |
| Number Of Medical Services | 3961 |
| Number Of Medicare Beneficiaries With Medical Services | 2038 |
| Total Medical Submitted Charge Amount | 674886 |
| Total Medical Medicare Allowed Amount | 117121.76 |
| Total Medical Medicare Payment Amount | 90433.25 |
| Total Medical Medicare Standardized Payment Amount | 85003.9 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 389 |
| Number Of Beneficiaries Age 65 to 74 | 518 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 540 |
| Number Of Female Beneficiaries | 1128 |
| Number Of Male Beneficiaries | 910 |
| Number Of Non Hispanic White Beneficiaries | 625 |
| Number Of Black or African American Beneficiaries | 350 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1024 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1466 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 45 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.6253 |