| National Provider Identifier [NPI]: | 1104891811 |
| Last Name Of The Provider | NORTHUP |
| First Name Of The Provider | HARRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 W 8TH ST |
| Street Address 2 Of The Provider | UFJP RADIOLOGY DEPT. |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322096511 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 5296 |
| Number Of Medicare Beneficiaries | 2491 |
| Total Submitted Charge Amount | 478038.3 |
| Total Medicare Allowed Amount | 85087.03 |
| Total Medicare Payment Amount | 61887.51 |
| Total Medicare Standardized Payment Amount | 61326.9 |
| 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 | 135 |
| Number Of Medical Services | 5296 |
| Number Of Medicare Beneficiaries With Medical Services | 2491 |
| Total Medical Submitted Charge Amount | 478038.3 |
| Total Medical Medicare Allowed Amount | 85087.03 |
| Total Medical Medicare Payment Amount | 61887.51 |
| Total Medical Medicare Standardized Payment Amount | 61326.9 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 931 |
| Number Of Beneficiaries Age 65 to 74 | 869 |
| Number Of Beneficiaries Age 75 to 84 | 495 |
| Number Of Beneficiaries Age Greater 84 | 196 |
| Number Of Female Beneficiaries | 1327 |
| Number Of Male Beneficiaries | 1164 |
| Number Of Non Hispanic White Beneficiaries | 1159 |
| Number Of Black or African American Beneficiaries | 1213 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 891 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1600 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4099 |