| National Provider Identifier [NPI]: | 1447256771 |
| Last Name Of The Provider | CARROLL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14302 BRUCE B DOWNS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336132601 |
| 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 | 205 |
| Number Of Services | 19885 |
| Number Of Medicare Beneficiaries | 2930 |
| Total Submitted Charge Amount | 1926275.2 |
| Total Medicare Allowed Amount | 516035.1 |
| Total Medicare Payment Amount | 398705.41 |
| Total Medicare Standardized Payment Amount | 412253.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 15254 |
| Number Of Medicare Beneficiaries With Drug Services | 295 |
| Total Drug Submitted ChargeAmount | 28951.57 |
| Total Drug Medicare AllowedAmount | 4071.04 |
| Total Drug Medicare PaymentAmount | 3155.76 |
| Total Drug Medicare Standardized Payment Amount | 3155.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 197 |
| Number Of Medical Services | 4631 |
| Number Of Medicare Beneficiaries With Medical Services | 2925 |
| Total Medical Submitted Charge Amount | 1897323.63 |
| Total Medical Medicare Allowed Amount | 511964.06 |
| Total Medical Medicare Payment Amount | 395549.65 |
| Total Medical Medicare Standardized Payment Amount | 409098.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 291 |
| Number Of Beneficiaries Age 65 to 74 | 1396 |
| Number Of Beneficiaries Age 75 to 84 | 944 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 1972 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 2453 |
| Number Of Black or African American Beneficiaries | 154 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 239 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 309 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2797 |