| National Provider Identifier [NPI]: | 1356304786 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 215 W 17TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOPKINSVILLE |
| Zip Code Of The Provider | 422401911 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 202 |
| Number Of Services | 11122 |
| Number Of Medicare Beneficiaries | 4472 |
| Total Submitted Charge Amount | 1305081.65 |
| Total Medicare Allowed Amount | 335921.07 |
| Total Medicare Payment Amount | 264109.66 |
| Total Medicare Standardized Payment Amount | 279854.15 |
| 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 | 202 |
| Number Of Medical Services | 11122 |
| Number Of Medicare Beneficiaries With Medical Services | 4472 |
| Total Medical Submitted Charge Amount | 1305081.65 |
| Total Medical Medicare Allowed Amount | 335921.07 |
| Total Medical Medicare Payment Amount | 264109.66 |
| Total Medical Medicare Standardized Payment Amount | 279854.15 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1226 |
| Number Of Beneficiaries Age 65 to 74 | 1577 |
| Number Of Beneficiaries Age 75 to 84 | 1124 |
| Number Of Beneficiaries Age Greater 84 | 545 |
| Number Of Female Beneficiaries | 2790 |
| Number Of Male Beneficiaries | 1682 |
| Number Of Non Hispanic White Beneficiaries | 3717 |
| Number Of Black or African American Beneficiaries | 678 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1588 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3923 |