| National Provider Identifier [NPI]: | 1174577266 |
| Last Name Of The Provider | PRY |
| First Name Of The Provider | RICHARD |
| 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 | 63 BARKLEY CIR |
| Street Address 2 Of The Provider | STE. 100 & 101 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339074514 |
| 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 | 233 |
| Number Of Services | 5430 |
| Number Of Medicare Beneficiaries | 3455 |
| Total Submitted Charge Amount | 554656 |
| Total Medicare Allowed Amount | 209781.33 |
| Total Medicare Payment Amount | 167261.68 |
| Total Medicare Standardized Payment Amount | 160939.18 |
| 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 | 233 |
| Number Of Medical Services | 5430 |
| Number Of Medicare Beneficiaries With Medical Services | 3455 |
| Total Medical Submitted Charge Amount | 554656 |
| Total Medical Medicare Allowed Amount | 209781.33 |
| Total Medical Medicare Payment Amount | 167261.68 |
| Total Medical Medicare Standardized Payment Amount | 160939.18 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 442 |
| Number Of Beneficiaries Age 65 to 74 | 1292 |
| Number Of Beneficiaries Age 75 to 84 | 1142 |
| Number Of Beneficiaries Age Greater 84 | 579 |
| Number Of Female Beneficiaries | 2185 |
| Number Of Male Beneficiaries | 1270 |
| Number Of Non Hispanic White Beneficiaries | 3062 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 188 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2791 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 664 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6225 |