| National Provider Identifier [NPI]: | 1609821958 |
| Last Name Of The Provider | ANTHONY |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13063 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346134838 |
| 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 | 172 |
| Number Of Services | 21292 |
| Number Of Medicare Beneficiaries | 1892 |
| Total Submitted Charge Amount | 1440734 |
| Total Medicare Allowed Amount | 403815.88 |
| Total Medicare Payment Amount | 315685.52 |
| Total Medicare Standardized Payment Amount | 338190.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17790 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 28608 |
| Total Drug Medicare AllowedAmount | 6551.62 |
| Total Drug Medicare PaymentAmount | 5095.44 |
| Total Drug Medicare Standardized Payment Amount | 5095.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 3502 |
| Number Of Medicare Beneficiaries With Medical Services | 1889 |
| Total Medical Submitted Charge Amount | 1412126 |
| Total Medical Medicare Allowed Amount | 397264.26 |
| Total Medical Medicare Payment Amount | 310590.08 |
| Total Medical Medicare Standardized Payment Amount | 333095.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 874 |
| Number Of Beneficiaries Age 75 to 84 | 616 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 1218 |
| Number Of Male Beneficiaries | 674 |
| Number Of Non Hispanic White Beneficiaries | 1723 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1724 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.348 |