| National Provider Identifier [NPI]: | 1487614111 |
| Last Name Of The Provider | SHIRLEY |
| First Name Of The Provider | STEVE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3599 UNIVERSITY BLVD S |
| Street Address 2 Of The Provider | BUILDING 300 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322164252 |
| 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 | 272 |
| Number Of Services | 6548 |
| Number Of Medicare Beneficiaries | 3654 |
| Total Submitted Charge Amount | 1021422 |
| Total Medicare Allowed Amount | 260895.46 |
| Total Medicare Payment Amount | 200823.12 |
| Total Medicare Standardized Payment Amount | 200317.45 |
| 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 | 272 |
| Number Of Medical Services | 6548 |
| Number Of Medicare Beneficiaries With Medical Services | 3654 |
| Total Medical Submitted Charge Amount | 1021422 |
| Total Medical Medicare Allowed Amount | 260895.46 |
| Total Medical Medicare Payment Amount | 200823.12 |
| Total Medical Medicare Standardized Payment Amount | 200317.45 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 410 |
| Number Of Beneficiaries Age 65 to 74 | 1341 |
| Number Of Beneficiaries Age 75 to 84 | 1117 |
| Number Of Beneficiaries Age Greater 84 | 786 |
| Number Of Female Beneficiaries | 2141 |
| Number Of Male Beneficiaries | 1513 |
| Number Of Non Hispanic White Beneficiaries | 3186 |
| Number Of Black or African American Beneficiaries | 278 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3095 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 559 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.848 |