| National Provider Identifier [NPI]: | 1508826785 |
| Last Name Of The Provider | BLACK |
| First Name Of The Provider | ROBERT |
| 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 | 1840 MEASE DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SAFETY HARBOR |
| Zip Code Of The Provider | 346956602 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 7259 |
| Number Of Medicare Beneficiaries | 2743 |
| Total Submitted Charge Amount | 1732980.74 |
| Total Medicare Allowed Amount | 615590.54 |
| Total Medicare Payment Amount | 466679.91 |
| Total Medicare Standardized Payment Amount | 470459.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 402 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 55464.96 |
| Total Drug Medicare AllowedAmount | 21134.87 |
| Total Drug Medicare PaymentAmount | 16569.62 |
| Total Drug Medicare Standardized Payment Amount | 16569.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 6857 |
| Number Of Medicare Beneficiaries With Medical Services | 2743 |
| Total Medical Submitted Charge Amount | 1677515.78 |
| Total Medical Medicare Allowed Amount | 594455.67 |
| Total Medical Medicare Payment Amount | 450110.29 |
| Total Medical Medicare Standardized Payment Amount | 453889.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 821 |
| Number Of Beneficiaries Age 75 to 84 | 851 |
| Number Of Beneficiaries Age Greater 84 | 752 |
| Number Of Female Beneficiaries | 1464 |
| Number Of Male Beneficiaries | 1279 |
| Number Of Non Hispanic White Beneficiaries | 2512 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2125 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 618 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0292 |