| National Provider Identifier [NPI]: | 1881643153 |
| Last Name Of The Provider | STORK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6716 NW 11TH PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326054215 |
| 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 | 180 |
| Number Of Services | 18955 |
| Number Of Medicare Beneficiaries | 5498 |
| Total Submitted Charge Amount | 1184750 |
| Total Medicare Allowed Amount | 380363.84 |
| Total Medicare Payment Amount | 287997.32 |
| Total Medicare Standardized Payment Amount | 292349.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 10409 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 51637 |
| Total Drug Medicare AllowedAmount | 2163.83 |
| Total Drug Medicare PaymentAmount | 1520.01 |
| Total Drug Medicare Standardized Payment Amount | 1520.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 8546 |
| Number Of Medicare Beneficiaries With Medical Services | 5496 |
| Total Medical Submitted Charge Amount | 1133113 |
| Total Medical Medicare Allowed Amount | 378200.01 |
| Total Medical Medicare Payment Amount | 286477.31 |
| Total Medical Medicare Standardized Payment Amount | 290829.67 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 821 |
| Number Of Beneficiaries Age 65 to 74 | 1922 |
| Number Of Beneficiaries Age 75 to 84 | 1785 |
| Number Of Beneficiaries Age Greater 84 | 970 |
| Number Of Female Beneficiaries | 3338 |
| Number Of Male Beneficiaries | 2160 |
| Number Of Non Hispanic White Beneficiaries | 4696 |
| Number Of Black or African American Beneficiaries | 616 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 122 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3913 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1585 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7841 |