| National Provider Identifier [NPI]: | 1588610026 |
| Last Name Of The Provider | MAZZELLA |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 BELFORT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322161431 |
| 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 | 231 |
| Number Of Services | 5707 |
| Number Of Medicare Beneficiaries | 3468 |
| Total Submitted Charge Amount | 976918 |
| Total Medicare Allowed Amount | 189870.75 |
| Total Medicare Payment Amount | 141758.99 |
| Total Medicare Standardized Payment Amount | 141397.92 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 651 |
| Number Of Beneficiaries Age 65 to 74 | 1306 |
| Number Of Beneficiaries Age 75 to 84 | 952 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 2072 |
| Number Of Male Beneficiaries | 1396 |
| Number Of Non Hispanic White Beneficiaries | 2703 |
| Number Of Black or African American Beneficiaries | 569 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2604 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 864 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8448 |