| National Provider Identifier [NPI]: | 1619037025 |
| Last Name Of The Provider | ROBERTO |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | SUITE# 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| 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 | 161 |
| Number Of Services | 25585 |
| Number Of Medicare Beneficiaries | 3952 |
| Total Submitted Charge Amount | 1765425.64 |
| Total Medicare Allowed Amount | 531694.38 |
| Total Medicare Payment Amount | 430187.65 |
| Total Medicare Standardized Payment Amount | 444809.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 19062 |
| Number Of Medicare Beneficiaries With Drug Services | 274 |
| Total Drug Submitted ChargeAmount | 26263.64 |
| Total Drug Medicare AllowedAmount | 4623.35 |
| Total Drug Medicare PaymentAmount | 3542.5 |
| Total Drug Medicare Standardized Payment Amount | 3542.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 6523 |
| Number Of Medicare Beneficiaries With Medical Services | 3951 |
| Total Medical Submitted Charge Amount | 1739162 |
| Total Medical Medicare Allowed Amount | 527071.03 |
| Total Medical Medicare Payment Amount | 426645.15 |
| Total Medical Medicare Standardized Payment Amount | 441267.38 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 503 |
| Number Of Beneficiaries Age 65 to 74 | 1860 |
| Number Of Beneficiaries Age 75 to 84 | 1138 |
| Number Of Beneficiaries Age Greater 84 | 451 |
| Number Of Female Beneficiaries | 2824 |
| Number Of Male Beneficiaries | 1128 |
| Number Of Non Hispanic White Beneficiaries | 3377 |
| Number Of Black or African American Beneficiaries | 364 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 118 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 534 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1925 |