| National Provider Identifier [NPI]: | 1518031434 |
| Last Name Of The Provider | SIORES |
| First Name Of The Provider | FREDERIC |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10011 WALTZING LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | LARGO |
| Zip Code Of The Provider | 337783434 |
| 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 | 142 |
| Number Of Services | 21141 |
| Number Of Medicare Beneficiaries | 2651 |
| Total Submitted Charge Amount | 1161520.6 |
| Total Medicare Allowed Amount | 434410.01 |
| Total Medicare Payment Amount | 334414.31 |
| Total Medicare Standardized Payment Amount | 344743.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 16616 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 16616 |
| Total Drug Medicare AllowedAmount | 3030 |
| Total Drug Medicare PaymentAmount | 2282.5 |
| Total Drug Medicare Standardized Payment Amount | 2282.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 4525 |
| Number Of Medicare Beneficiaries With Medical Services | 2651 |
| Total Medical Submitted Charge Amount | 1144904.6 |
| Total Medical Medicare Allowed Amount | 431380.01 |
| Total Medical Medicare Payment Amount | 332131.81 |
| Total Medical Medicare Standardized Payment Amount | 342461.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 1066 |
| Number Of Beneficiaries Age 75 to 84 | 930 |
| Number Of Beneficiaries Age Greater 84 | 483 |
| Number Of Female Beneficiaries | 1734 |
| Number Of Male Beneficiaries | 917 |
| Number Of Non Hispanic White Beneficiaries | 2506 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2446 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 205 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2554 |