| National Provider Identifier [NPI]: | 1730151903 |
| Last Name Of The Provider | MERGO |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 72266 |
| Number Of Medicare Beneficiaries | 2407 |
| Total Submitted Charge Amount | 559483.81 |
| Total Medicare Allowed Amount | 357349.42 |
| Total Medicare Payment Amount | 266681.36 |
| Total Medicare Standardized Payment Amount | 308819.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 68608 |
| Number Of Medicare Beneficiaries With Drug Services | 518 |
| Total Drug Submitted ChargeAmount | 24284.34 |
| Total Drug Medicare AllowedAmount | 14569.86 |
| Total Drug Medicare PaymentAmount | 10137.41 |
| Total Drug Medicare Standardized Payment Amount | 10137.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 3658 |
| Number Of Medicare Beneficiaries With Medical Services | 2376 |
| Total Medical Submitted Charge Amount | 535199.47 |
| Total Medical Medicare Allowed Amount | 342779.56 |
| Total Medical Medicare Payment Amount | 256543.95 |
| Total Medical Medicare Standardized Payment Amount | 298681.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 367 |
| Number Of Beneficiaries Age 65 to 74 | 989 |
| Number Of Beneficiaries Age 75 to 84 | 716 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 1181 |
| Number Of Male Beneficiaries | 1226 |
| Number Of Non Hispanic White Beneficiaries | 2071 |
| Number Of Black or African American Beneficiaries | 200 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0693 |