| National Provider Identifier [NPI]: | 1609808369 |
| Last Name Of The Provider | BLACK |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | STE. 500 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013871 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 257 |
| Number Of Services | 8981 |
| Number Of Medicare Beneficiaries | 5362 |
| Total Submitted Charge Amount | 1150809 |
| Total Medicare Allowed Amount | 257082.95 |
| Total Medicare Payment Amount | 194238.56 |
| Total Medicare Standardized Payment Amount | 202272.66 |
| 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 | 257 |
| Number Of Medical Services | 8981 |
| Number Of Medicare Beneficiaries With Medical Services | 5362 |
| Total Medical Submitted Charge Amount | 1150809 |
| Total Medical Medicare Allowed Amount | 257082.95 |
| Total Medical Medicare Payment Amount | 194238.56 |
| Total Medical Medicare Standardized Payment Amount | 202272.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 885 |
| Number Of Beneficiaries Age 65 to 74 | 2022 |
| Number Of Beneficiaries Age 75 to 84 | 1622 |
| Number Of Beneficiaries Age Greater 84 | 833 |
| Number Of Female Beneficiaries | 3134 |
| Number Of Male Beneficiaries | 2228 |
| Number Of Non Hispanic White Beneficiaries | 4993 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3877 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1485 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6307 |