| National Provider Identifier [NPI]: | 1164692711 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | MELANIE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4354A OLD SHELL RD # 324 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366082011 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 3086 |
| Number Of Medicare Beneficiaries | 1106 |
| Total Submitted Charge Amount | 189652 |
| Total Medicare Allowed Amount | 76614.51 |
| Total Medicare Payment Amount | 55918.86 |
| Total Medicare Standardized Payment Amount | 61970.56 |
| 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 | 117 |
| Number Of Medical Services | 3086 |
| Number Of Medicare Beneficiaries With Medical Services | 1106 |
| Total Medical Submitted Charge Amount | 189652 |
| Total Medical Medicare Allowed Amount | 76614.51 |
| Total Medical Medicare Payment Amount | 55918.86 |
| Total Medical Medicare Standardized Payment Amount | 61970.56 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 395 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 593 |
| Number Of Male Beneficiaries | 513 |
| Number Of Non Hispanic White Beneficiaries | 647 |
| Number Of Black or African American Beneficiaries | 419 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 688 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 418 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5454 |