| National Provider Identifier [NPI]: | 1578507588 |
| Last Name Of The Provider | CARROLL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | SUITE # 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| 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 | 198 |
| Number Of Services | 24566.5 |
| Number Of Medicare Beneficiaries | 3111 |
| Total Submitted Charge Amount | 1772777.76 |
| Total Medicare Allowed Amount | 519995.81 |
| Total Medicare Payment Amount | 416569.16 |
| Total Medicare Standardized Payment Amount | 430377.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 19492.5 |
| Number Of Medicare Beneficiaries With Drug Services | 331 |
| Total Drug Submitted ChargeAmount | 30257.76 |
| Total Drug Medicare AllowedAmount | 5929.43 |
| Total Drug Medicare PaymentAmount | 4607.18 |
| Total Drug Medicare Standardized Payment Amount | 4607.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 5074 |
| Number Of Medicare Beneficiaries With Medical Services | 3107 |
| Total Medical Submitted Charge Amount | 1742520 |
| Total Medical Medicare Allowed Amount | 514066.38 |
| Total Medical Medicare Payment Amount | 411961.98 |
| Total Medical Medicare Standardized Payment Amount | 425770.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 418 |
| Number Of Beneficiaries Age 65 to 74 | 1287 |
| Number Of Beneficiaries Age 75 to 84 | 1011 |
| Number Of Beneficiaries Age Greater 84 | 395 |
| Number Of Female Beneficiaries | 2116 |
| Number Of Male Beneficiaries | 995 |
| Number Of Non Hispanic White Beneficiaries | 2845 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 479 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3142 |