| National Provider Identifier [NPI]: | 1548295421 |
| Last Name Of The Provider | WHITLOCK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1503 CLUB MANOR DR STE B |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAUMELLE |
| Zip Code Of The Provider | 721136089 |
| 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 | 152 |
| Number Of Services | 8203 |
| Number Of Medicare Beneficiaries | 3640 |
| Total Submitted Charge Amount | 946804.4 |
| Total Medicare Allowed Amount | 221375.38 |
| Total Medicare Payment Amount | 171942.71 |
| Total Medicare Standardized Payment Amount | 185058.65 |
| 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 | 152 |
| Number Of Medical Services | 8203 |
| Number Of Medicare Beneficiaries With Medical Services | 3640 |
| Total Medical Submitted Charge Amount | 946804.4 |
| Total Medical Medicare Allowed Amount | 221375.38 |
| Total Medical Medicare Payment Amount | 171942.71 |
| Total Medical Medicare Standardized Payment Amount | 185058.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 557 |
| Number Of Beneficiaries Age 65 to 74 | 1526 |
| Number Of Beneficiaries Age 75 to 84 | 1145 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 1852 |
| Number Of Male Beneficiaries | 1788 |
| Number Of Non Hispanic White Beneficiaries | 3278 |
| Number Of Black or African American Beneficiaries | 324 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3088 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 552 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3883 |