| National Provider Identifier [NPI]: | 1851568489 |
| Last Name Of The Provider | MCCLINTOCK |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 N. ELM STREET |
| Street Address 2 Of The Provider | STE. 200 |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274016304 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1787 |
| Number Of Medicare Beneficiaries | 1283 |
| Total Submitted Charge Amount | 246892.37 |
| Total Medicare Allowed Amount | 63876.95 |
| Total Medicare Payment Amount | 49865.07 |
| Total Medicare Standardized Payment Amount | 49772.99 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 439 |
| Number Of Beneficiaries Age 65 to 74 | 343 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 723 |
| Number Of Male Beneficiaries | 560 |
| Number Of Non Hispanic White Beneficiaries | 966 |
| Number Of Black or African American Beneficiaries | 290 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9974 |