| National Provider Identifier [NPI]: | 1841298569 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1948 1ST AVE NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CEDAR RAPIDS |
| Zip Code Of The Provider | 524025321 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 5934 |
| Number Of Medicare Beneficiaries | 3775 |
| Total Submitted Charge Amount | 442505.41 |
| Total Medicare Allowed Amount | 123425.89 |
| Total Medicare Payment Amount | 91986.12 |
| Total Medicare Standardized Payment Amount | 99080.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1231 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 629.7 |
| Total Drug Medicare AllowedAmount | 258.64 |
| Total Drug Medicare PaymentAmount | 168.86 |
| Total Drug Medicare Standardized Payment Amount | 168.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 4703 |
| Number Of Medicare Beneficiaries With Medical Services | 3775 |
| Total Medical Submitted Charge Amount | 441875.71 |
| Total Medical Medicare Allowed Amount | 123167.25 |
| Total Medical Medicare Payment Amount | 91817.26 |
| Total Medical Medicare Standardized Payment Amount | 98912.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 503 |
| Number Of Beneficiaries Age 65 to 74 | 1315 |
| Number Of Beneficiaries Age 75 to 84 | 1227 |
| Number Of Beneficiaries Age Greater 84 | 730 |
| Number Of Female Beneficiaries | 2342 |
| Number Of Male Beneficiaries | 1433 |
| Number Of Non Hispanic White Beneficiaries | 3668 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3022 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 753 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3889 |