| National Provider Identifier [NPI]: | 1891728655 |
| Last Name Of The Provider | ROY-CLARK |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 49 2ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESQUE ISLE |
| Zip Code Of The Provider | 047692637 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 5014 |
| Number Of Medicare Beneficiaries | 2064 |
| Total Submitted Charge Amount | 357105 |
| Total Medicare Allowed Amount | 114027.02 |
| Total Medicare Payment Amount | 84841.83 |
| Total Medicare Standardized Payment Amount | 89760.62 |
| 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 | 131 |
| Number Of Medical Services | 5014 |
| Number Of Medicare Beneficiaries With Medical Services | 2064 |
| Total Medical Submitted Charge Amount | 357105 |
| Total Medical Medicare Allowed Amount | 114027.02 |
| Total Medical Medicare Payment Amount | 84841.83 |
| Total Medical Medicare Standardized Payment Amount | 89760.62 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 474 |
| Number Of Beneficiaries Age 65 to 74 | 715 |
| Number Of Beneficiaries Age 75 to 84 | 571 |
| Number Of Beneficiaries Age Greater 84 | 304 |
| Number Of Female Beneficiaries | 1309 |
| Number Of Male Beneficiaries | 755 |
| Number Of Non Hispanic White Beneficiaries | 2009 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 813 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1251 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.315 |