| National Provider Identifier [NPI]: | 1023098928 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | BRADLY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1275 YORK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100216007 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 8961 |
| Number Of Medicare Beneficiaries | 4513 |
| Total Submitted Charge Amount | 1362220.7 |
| Total Medicare Allowed Amount | 418289.96 |
| Total Medicare Payment Amount | 364131.17 |
| Total Medicare Standardized Payment Amount | 323955.31 |
| 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 | 31 |
| Number Of Medical Services | 8961 |
| Number Of Medicare Beneficiaries With Medical Services | 4513 |
| Total Medical Submitted Charge Amount | 1362220.7 |
| Total Medical Medicare Allowed Amount | 418289.96 |
| Total Medical Medicare Payment Amount | 364131.17 |
| Total Medical Medicare Standardized Payment Amount | 323955.31 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 849 |
| Number Of Beneficiaries Age 65 to 74 | 2644 |
| Number Of Beneficiaries Age 75 to 84 | 879 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 3953 |
| Number Of Male Beneficiaries | 560 |
| Number Of Non Hispanic White Beneficiaries | 3631 |
| Number Of Black or African American Beneficiaries | 487 |
| Number Of AsianPacific Islander Beneficiaries | 90 |
| Number Of Hispanic Beneficiaries | 235 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3765 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 748 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8533 |