| National Provider Identifier [NPI]: | 1396799342 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 S UNIVERSITY AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722055302 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 9341 |
| Number Of Medicare Beneficiaries | 4986 |
| Total Submitted Charge Amount | 660236 |
| Total Medicare Allowed Amount | 236352.45 |
| Total Medicare Payment Amount | 188096.95 |
| Total Medicare Standardized Payment Amount | 202384.76 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 982 |
| Number Of Beneficiaries Age 65 to 74 | 1880 |
| Number Of Beneficiaries Age 75 to 84 | 1418 |
| Number Of Beneficiaries Age Greater 84 | 706 |
| Number Of Female Beneficiaries | 3609 |
| Number Of Male Beneficiaries | 1377 |
| Number Of Non Hispanic White Beneficiaries | 4599 |
| Number Of Black or African American Beneficiaries | 303 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3710 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1276 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2549 |