| National Provider Identifier [NPI]: | 1669453338 |
| Last Name Of The Provider | REILLY |
| First Name Of The Provider | CLARENCE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 S TAMIAMI TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342393509 |
| 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 | 218 |
| Number Of Services | 6714 |
| Number Of Medicare Beneficiaries | 3605 |
| Total Submitted Charge Amount | 1107615.63 |
| Total Medicare Allowed Amount | 219097.57 |
| Total Medicare Payment Amount | 169590.32 |
| Total Medicare Standardized Payment Amount | 171719.61 |
| 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 | 218 |
| Number Of Medical Services | 6714 |
| Number Of Medicare Beneficiaries With Medical Services | 3605 |
| Total Medical Submitted Charge Amount | 1107615.63 |
| Total Medical Medicare Allowed Amount | 219097.57 |
| Total Medical Medicare Payment Amount | 169590.32 |
| Total Medical Medicare Standardized Payment Amount | 171719.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 758 |
| Number Of Beneficiaries Age 65 to 74 | 1191 |
| Number Of Beneficiaries Age 75 to 84 | 1057 |
| Number Of Beneficiaries Age Greater 84 | 599 |
| Number Of Female Beneficiaries | 2193 |
| Number Of Male Beneficiaries | 1412 |
| Number Of Non Hispanic White Beneficiaries | 3481 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2458 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1147 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6968 |