| National Provider Identifier [NPI]: | 1700825940 |
| Last Name Of The Provider | FRIDAY |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 BUSINESS PARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOODLETTSVILLE |
| Zip Code Of The Provider | 370723132 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 217 |
| Number Of Services | 3465 |
| Number Of Medicare Beneficiaries | 1045 |
| Total Submitted Charge Amount | 697654.39 |
| Total Medicare Allowed Amount | 143380.71 |
| Total Medicare Payment Amount | 110395.92 |
| Total Medicare Standardized Payment Amount | 118612.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1429 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 365 |
| Total Drug Medicare AllowedAmount | 322.53 |
| Total Drug Medicare PaymentAmount | 243.45 |
| Total Drug Medicare Standardized Payment Amount | 243.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 215 |
| Number Of Medical Services | 2036 |
| Number Of Medicare Beneficiaries With Medical Services | 1045 |
| Total Medical Submitted Charge Amount | 697289.39 |
| Total Medical Medicare Allowed Amount | 143058.18 |
| Total Medical Medicare Payment Amount | 110152.47 |
| Total Medical Medicare Standardized Payment Amount | 118368.75 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 290 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 585 |
| Number Of Male Beneficiaries | 460 |
| Number Of Non Hispanic White Beneficiaries | 866 |
| Number Of Black or African American Beneficiaries | 163 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 772 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0888 |