| National Provider Identifier [NPI]: | 1699701011 |
| Last Name Of The Provider | WASSERMAN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| 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 |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 2727 |
| Number Of Medicare Beneficiaries | 1469 |
| Total Submitted Charge Amount | 219194 |
| Total Medicare Allowed Amount | 47190.37 |
| Total Medicare Payment Amount | 33586.23 |
| Total Medicare Standardized Payment Amount | 33618.33 |
| 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 | 110 |
| Number Of Medical Services | 2727 |
| Number Of Medicare Beneficiaries With Medical Services | 1469 |
| Total Medical Submitted Charge Amount | 219194 |
| Total Medical Medicare Allowed Amount | 47190.37 |
| Total Medical Medicare Payment Amount | 33586.23 |
| Total Medical Medicare Standardized Payment Amount | 33618.33 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 587 |
| Number Of Beneficiaries Age 65 to 74 | 483 |
| Number Of Beneficiaries Age 75 to 84 | 294 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 873 |
| Number Of Male Beneficiaries | 596 |
| Number Of Non Hispanic White Beneficiaries | 729 |
| Number Of Black or African American Beneficiaries | 685 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 530 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 939 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2311 |