| National Provider Identifier [NPI]: | 1972552065 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6201 N SUNCOAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344286712 |
| 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 | 219 |
| Number Of Services | 18186 |
| Number Of Medicare Beneficiaries | 5998 |
| Total Submitted Charge Amount | 1344269 |
| Total Medicare Allowed Amount | 518674.6 |
| Total Medicare Payment Amount | 395539.63 |
| Total Medicare Standardized Payment Amount | 397208.29 |
| 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 | 219 |
| Number Of Medical Services | 18186 |
| Number Of Medicare Beneficiaries With Medical Services | 5998 |
| Total Medical Submitted Charge Amount | 1344269 |
| Total Medical Medicare Allowed Amount | 518674.6 |
| Total Medical Medicare Payment Amount | 395539.63 |
| Total Medical Medicare Standardized Payment Amount | 397208.29 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 866 |
| Number Of Beneficiaries Age 65 to 74 | 2222 |
| Number Of Beneficiaries Age 75 to 84 | 1970 |
| Number Of Beneficiaries Age Greater 84 | 940 |
| Number Of Female Beneficiaries | 3609 |
| Number Of Male Beneficiaries | 2389 |
| Number Of Non Hispanic White Beneficiaries | 5669 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1219 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5029 |