| National Provider Identifier [NPI]: | 1881866341 |
| Last Name Of The Provider | ANTONIETTI |
| First Name Of The Provider | LETIZIA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 K ST |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958165120 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 8605 |
| Number Of Medicare Beneficiaries | 1821 |
| Total Submitted Charge Amount | 842245 |
| Total Medicare Allowed Amount | 164867.82 |
| Total Medicare Payment Amount | 125429.7 |
| Total Medicare Standardized Payment Amount | 122620.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6212 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 13600 |
| Total Drug Medicare AllowedAmount | 2101.34 |
| Total Drug Medicare PaymentAmount | 1647.42 |
| Total Drug Medicare Standardized Payment Amount | 1647.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 2393 |
| Number Of Medicare Beneficiaries With Medical Services | 1821 |
| Total Medical Submitted Charge Amount | 828645 |
| Total Medical Medicare Allowed Amount | 162766.48 |
| Total Medical Medicare Payment Amount | 123782.28 |
| Total Medical Medicare Standardized Payment Amount | 120972.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 328 |
| Number Of Beneficiaries Age 65 to 74 | 626 |
| Number Of Beneficiaries Age 75 to 84 | 529 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 1032 |
| Number Of Male Beneficiaries | 789 |
| Number Of Non Hispanic White Beneficiaries | 1364 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | 125 |
| Number Of Hispanic Beneficiaries | 159 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 534 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 1.7638 |