| National Provider Identifier [NPI]: | 1144275926 |
| Last Name Of The Provider | PEREZ |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11375 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346135409 |
| 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 | 180 |
| Number Of Services | 9734 |
| Number Of Medicare Beneficiaries | 4649 |
| Total Submitted Charge Amount | 2843157.65 |
| Total Medicare Allowed Amount | 1069323.99 |
| Total Medicare Payment Amount | 865862.46 |
| Total Medicare Standardized Payment Amount | 907854.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 434 |
| Number Of Medicare Beneficiaries With Drug Services | 391 |
| Total Drug Submitted ChargeAmount | 70104 |
| Total Drug Medicare AllowedAmount | 423.22 |
| Total Drug Medicare PaymentAmount | 333.35 |
| Total Drug Medicare Standardized Payment Amount | 333.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 9300 |
| Number Of Medicare Beneficiaries With Medical Services | 4647 |
| Total Medical Submitted Charge Amount | 2773053.65 |
| Total Medical Medicare Allowed Amount | 1068900.77 |
| Total Medical Medicare Payment Amount | 865529.11 |
| Total Medical Medicare Standardized Payment Amount | 907521.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 624 |
| Number Of Beneficiaries Age 65 to 74 | 2053 |
| Number Of Beneficiaries Age 75 to 84 | 1507 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 3167 |
| Number Of Male Beneficiaries | 1482 |
| Number Of Non Hispanic White Beneficiaries | 4215 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 229 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 614 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4127 |