| National Provider Identifier [NPI]: | 1104883008 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | DARWIN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 W KALEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328062931 |
| 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 | 222 |
| Number Of Services | 5442 |
| Number Of Medicare Beneficiaries | 3521 |
| Total Submitted Charge Amount | 622220 |
| Total Medicare Allowed Amount | 176731.33 |
| Total Medicare Payment Amount | 130423.2 |
| Total Medicare Standardized Payment Amount | 131234.54 |
| 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 | 222 |
| Number Of Medical Services | 5442 |
| Number Of Medicare Beneficiaries With Medical Services | 3521 |
| Total Medical Submitted Charge Amount | 622220 |
| Total Medical Medicare Allowed Amount | 176731.33 |
| Total Medical Medicare Payment Amount | 130423.2 |
| Total Medical Medicare Standardized Payment Amount | 131234.54 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 1229 |
| Number Of Beneficiaries Age 75 to 84 | 1062 |
| Number Of Beneficiaries Age Greater 84 | 618 |
| Number Of Female Beneficiaries | 2140 |
| Number Of Male Beneficiaries | 1381 |
| Number Of Non Hispanic White Beneficiaries | 2588 |
| Number Of Black or African American Beneficiaries | 461 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 354 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2562 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 959 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1474 |