| National Provider Identifier [NPI]: | 1932208568 |
| Last Name Of The Provider | PORT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9602 STOCKDALE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAKERSFIELD |
| Zip Code Of The Provider | 93311 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 219 |
| Number Of Services | 7168 |
| Number Of Medicare Beneficiaries | 3592 |
| Total Submitted Charge Amount | 487294.94 |
| Total Medicare Allowed Amount | 232794.19 |
| Total Medicare Payment Amount | 178018.6 |
| Total Medicare Standardized Payment Amount | 180129.77 |
| 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 | 219 |
| Number Of Medical Services | 7168 |
| Number Of Medicare Beneficiaries With Medical Services | 3592 |
| Total Medical Submitted Charge Amount | 487294.94 |
| Total Medical Medicare Allowed Amount | 232794.19 |
| Total Medical Medicare Payment Amount | 178018.6 |
| Total Medical Medicare Standardized Payment Amount | 180129.77 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 816 |
| Number Of Beneficiaries Age 65 to 74 | 1479 |
| Number Of Beneficiaries Age 75 to 84 | 908 |
| Number Of Beneficiaries Age Greater 84 | 389 |
| Number Of Female Beneficiaries | 2109 |
| Number Of Male Beneficiaries | 1483 |
| Number Of Non Hispanic White Beneficiaries | 2237 |
| Number Of Black or African American Beneficiaries | 230 |
| Number Of AsianPacific Islander Beneficiaries | 110 |
| Number Of Hispanic Beneficiaries | 951 |
| Number Of American Indian Alaska Native Beneficiaries | 30 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1927 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1665 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8552 |