| National Provider Identifier [NPI]: | 1407894421 |
| Last Name Of The Provider | BANULL |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| 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 | 149 |
| Number Of Services | 8421 |
| Number Of Medicare Beneficiaries | 2671 |
| Total Submitted Charge Amount | 832869.99 |
| Total Medicare Allowed Amount | 239788.95 |
| Total Medicare Payment Amount | 197269.85 |
| Total Medicare Standardized Payment Amount | 199883.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3735 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 8343 |
| Total Drug Medicare AllowedAmount | 998.27 |
| Total Drug Medicare PaymentAmount | 740.64 |
| Total Drug Medicare Standardized Payment Amount | 740.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 147 |
| Number Of Medical Services | 4686 |
| Number Of Medicare Beneficiaries With Medical Services | 2671 |
| Total Medical Submitted Charge Amount | 824526.99 |
| Total Medical Medicare Allowed Amount | 238790.68 |
| Total Medical Medicare Payment Amount | 196529.21 |
| Total Medical Medicare Standardized Payment Amount | 199142.52 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 277 |
| Number Of Beneficiaries Age 65 to 74 | 995 |
| Number Of Beneficiaries Age 75 to 84 | 870 |
| Number Of Beneficiaries Age Greater 84 | 529 |
| Number Of Female Beneficiaries | 1987 |
| Number Of Male Beneficiaries | 684 |
| Number Of Non Hispanic White Beneficiaries | 2474 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 87 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5941 |