| National Provider Identifier [NPI]: | 1891765061 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 LAUREL AVE |
| Street Address 2 Of The Provider | SUITE N304 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379161810 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 6110 |
| Number Of Medicare Beneficiaries | 3984 |
| Total Submitted Charge Amount | 539724.54 |
| Total Medicare Allowed Amount | 132383.59 |
| Total Medicare Payment Amount | 102086.32 |
| Total Medicare Standardized Payment Amount | 109264.27 |
| 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 | 179 |
| Number Of Medical Services | 6110 |
| Number Of Medicare Beneficiaries With Medical Services | 3984 |
| Total Medical Submitted Charge Amount | 539724.54 |
| Total Medical Medicare Allowed Amount | 132383.59 |
| Total Medical Medicare Payment Amount | 102086.32 |
| Total Medical Medicare Standardized Payment Amount | 109264.27 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 778 |
| Number Of Beneficiaries Age 65 to 74 | 1579 |
| Number Of Beneficiaries Age 75 to 84 | 1083 |
| Number Of Beneficiaries Age Greater 84 | 544 |
| Number Of Female Beneficiaries | 2471 |
| Number Of Male Beneficiaries | 1513 |
| Number Of Non Hispanic White Beneficiaries | 3740 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2967 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1017 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6375 |