| National Provider Identifier [NPI]: | 1275575144 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | JUDY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 SAXON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORANGE CITY |
| Zip Code Of The Provider | 327638468 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 903 |
| Number Of Medicare Beneficiaries | 774 |
| Total Submitted Charge Amount | 661529 |
| Total Medicare Allowed Amount | 129156.29 |
| Total Medicare Payment Amount | 99086.11 |
| Total Medicare Standardized Payment Amount | 97348.56 |
| 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 | 25 |
| Number Of Medical Services | 903 |
| Number Of Medicare Beneficiaries With Medical Services | 774 |
| Total Medical Submitted Charge Amount | 661529 |
| Total Medical Medicare Allowed Amount | 129156.29 |
| Total Medical Medicare Payment Amount | 99086.11 |
| Total Medical Medicare Standardized Payment Amount | 97348.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 250 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 430 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 714 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 600 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 174 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6903 |