| National Provider Identifier [NPI]: | 1558351320 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| 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 | 251 |
| Number Of Services | 5093 |
| Number Of Medicare Beneficiaries | 2403 |
| Total Submitted Charge Amount | 907734.48 |
| Total Medicare Allowed Amount | 181283.57 |
| Total Medicare Payment Amount | 140071.02 |
| Total Medicare Standardized Payment Amount | 139230.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1256 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 3036.48 |
| Total Drug Medicare AllowedAmount | 476.34 |
| Total Drug Medicare PaymentAmount | 373.42 |
| Total Drug Medicare Standardized Payment Amount | 373.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 248 |
| Number Of Medical Services | 3837 |
| Number Of Medicare Beneficiaries With Medical Services | 2403 |
| Total Medical Submitted Charge Amount | 904698 |
| Total Medical Medicare Allowed Amount | 180807.23 |
| Total Medical Medicare Payment Amount | 139697.6 |
| Total Medical Medicare Standardized Payment Amount | 138856.67 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 336 |
| Number Of Beneficiaries Age 65 to 74 | 663 |
| Number Of Beneficiaries Age 75 to 84 | 740 |
| Number Of Beneficiaries Age Greater 84 | 664 |
| Number Of Female Beneficiaries | 1420 |
| Number Of Male Beneficiaries | 983 |
| Number Of Non Hispanic White Beneficiaries | 2195 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1773 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 630 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.1815 |