| National Provider Identifier [NPI]: | 1669441150 |
| Last Name Of The Provider | USILTON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2120 LAKELAND HILLS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKELAND |
| Zip Code Of The Provider | 338052906 |
| 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 | 109 |
| Number Of Services | 5104 |
| Number Of Medicare Beneficiaries | 2701 |
| Total Submitted Charge Amount | 518949 |
| Total Medicare Allowed Amount | 127240.33 |
| Total Medicare Payment Amount | 94600.15 |
| Total Medicare Standardized Payment Amount | 95885.78 |
| 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 | 109 |
| Number Of Medical Services | 5104 |
| Number Of Medicare Beneficiaries With Medical Services | 2701 |
| Total Medical Submitted Charge Amount | 518949 |
| Total Medical Medicare Allowed Amount | 127240.33 |
| Total Medical Medicare Payment Amount | 94600.15 |
| Total Medical Medicare Standardized Payment Amount | 95885.78 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 539 |
| Number Of Beneficiaries Age 65 to 74 | 778 |
| Number Of Beneficiaries Age 75 to 84 | 853 |
| Number Of Beneficiaries Age Greater 84 | 531 |
| Number Of Female Beneficiaries | 1472 |
| Number Of Male Beneficiaries | 1229 |
| Number Of Non Hispanic White Beneficiaries | 2180 |
| Number Of Black or African American Beneficiaries | 336 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1001 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.392 |