| National Provider Identifier [NPI]: | 1568491892 |
| Last Name Of The Provider | MCCLAIN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1710 HARRISON ST |
| Street Address 2 Of The Provider | WHITE RIVER MEDICAL CENTER |
| City Of The Provider | BATESVILLE |
| Zip Code Of The Provider | 725017303 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 253 |
| Number Of Services | 7575 |
| Number Of Medicare Beneficiaries | 4115 |
| Total Submitted Charge Amount | 776198 |
| Total Medicare Allowed Amount | 237491.86 |
| Total Medicare Payment Amount | 181406.63 |
| Total Medicare Standardized Payment Amount | 196626.09 |
| 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 | 253 |
| Number Of Medical Services | 7575 |
| Number Of Medicare Beneficiaries With Medical Services | 4115 |
| Total Medical Submitted Charge Amount | 776198 |
| Total Medical Medicare Allowed Amount | 237491.86 |
| Total Medical Medicare Payment Amount | 181406.63 |
| Total Medical Medicare Standardized Payment Amount | 196626.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 871 |
| Number Of Beneficiaries Age 65 to 74 | 1411 |
| Number Of Beneficiaries Age 75 to 84 | 1215 |
| Number Of Beneficiaries Age Greater 84 | 618 |
| Number Of Female Beneficiaries | 2485 |
| Number Of Male Beneficiaries | 1630 |
| Number Of Non Hispanic White Beneficiaries | 3996 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2753 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1362 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.426 |