| National Provider Identifier [NPI]: | 1881691764 |
| Last Name Of The Provider | KAUFMAN |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7630 CROSSTREE LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322562347 |
| 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 | 32 |
| Number Of Services | 13059 |
| Number Of Medicare Beneficiaries | 6136 |
| Total Submitted Charge Amount | 1958850 |
| Total Medicare Allowed Amount | 142303.18 |
| Total Medicare Payment Amount | 111439.14 |
| Total Medicare Standardized Payment Amount | 103346.41 |
| 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 | 32 |
| Number Of Medical Services | 13059 |
| Number Of Medicare Beneficiaries With Medical Services | 6136 |
| Total Medical Submitted Charge Amount | 1958850 |
| Total Medical Medicare Allowed Amount | 142303.18 |
| Total Medical Medicare Payment Amount | 111439.14 |
| Total Medical Medicare Standardized Payment Amount | 103346.41 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 762 |
| Number Of Beneficiaries Age 65 to 74 | 1085 |
| Number Of Beneficiaries Age 75 to 84 | 1679 |
| Number Of Beneficiaries Age Greater 84 | 2610 |
| Number Of Female Beneficiaries | 3978 |
| Number Of Male Beneficiaries | 2158 |
| Number Of Non Hispanic White Beneficiaries | 4185 |
| Number Of Black or African American Beneficiaries | 1198 |
| Number Of AsianPacific Islander Beneficiaries | 205 |
| Number Of Hispanic Beneficiaries | 491 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3436 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 61 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.4826 |