| National Provider Identifier [NPI]: | 1730176991 |
| Last Name Of The Provider | BLACKSHEAR |
| First Name Of The Provider | JOSEPH |
| 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 | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 2765 |
| Number Of Medicare Beneficiaries | 1304 |
| Total Submitted Charge Amount | 282530.29 |
| Total Medicare Allowed Amount | 212734.66 |
| Total Medicare Payment Amount | 160376.5 |
| Total Medicare Standardized Payment Amount | 172854.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 382 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 22197.01 |
| Total Drug Medicare AllowedAmount | 17305.97 |
| Total Drug Medicare PaymentAmount | 13159.8 |
| Total Drug Medicare Standardized Payment Amount | 13159.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 2383 |
| Number Of Medicare Beneficiaries With Medical Services | 1286 |
| Total Medical Submitted Charge Amount | 260333.28 |
| Total Medical Medicare Allowed Amount | 195428.69 |
| Total Medical Medicare Payment Amount | 147216.7 |
| Total Medical Medicare Standardized Payment Amount | 159694.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 500 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 228 |
| Number Of Female Beneficiaries | 570 |
| Number Of Male Beneficiaries | 734 |
| Number Of Non Hispanic White Beneficiaries | 1153 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1221 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6701 |