| National Provider Identifier [NPI]: | 1396729810 |
| Last Name Of The Provider | PRESTON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D., J.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 122 4TH AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | INDIALANTIC |
| Zip Code Of The Provider | 329033112 |
| 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 | 191 |
| Number Of Services | 33527 |
| Number Of Medicare Beneficiaries | 2617 |
| Total Submitted Charge Amount | 1354912.19 |
| Total Medicare Allowed Amount | 664264.97 |
| Total Medicare Payment Amount | 526508.53 |
| Total Medicare Standardized Payment Amount | 542210.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 28261 |
| Number Of Medicare Beneficiaries With Drug Services | 349 |
| Total Drug Submitted ChargeAmount | 42536.36 |
| Total Drug Medicare AllowedAmount | 21220.4 |
| Total Drug Medicare PaymentAmount | 16435.95 |
| Total Drug Medicare Standardized Payment Amount | 16435.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 5266 |
| Number Of Medicare Beneficiaries With Medical Services | 2611 |
| Total Medical Submitted Charge Amount | 1312375.83 |
| Total Medical Medicare Allowed Amount | 643044.57 |
| Total Medical Medicare Payment Amount | 510072.58 |
| Total Medical Medicare Standardized Payment Amount | 525774.52 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 292 |
| Number Of Beneficiaries Age 65 to 74 | 1311 |
| Number Of Beneficiaries Age 75 to 84 | 754 |
| Number Of Beneficiaries Age Greater 84 | 260 |
| Number Of Female Beneficiaries | 1798 |
| Number Of Male Beneficiaries | 819 |
| Number Of Non Hispanic White Beneficiaries | 2298 |
| Number Of Black or African American Beneficiaries | 125 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1048 |