| National Provider Identifier [NPI]: | 1710969217 |
| Last Name Of The Provider | MANUEL |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13400 SUTTON PARK DR S |
| Street Address 2 Of The Provider | SUITE 1103 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322240236 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 11169 |
| Number Of Medicare Beneficiaries | 1800 |
| Total Submitted Charge Amount | 1179044 |
| Total Medicare Allowed Amount | 732914.77 |
| Total Medicare Payment Amount | 564261.9 |
| Total Medicare Standardized Payment Amount | 575857.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1285 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 15695 |
| Total Drug Medicare AllowedAmount | 9742.85 |
| Total Drug Medicare PaymentAmount | 7620.47 |
| Total Drug Medicare Standardized Payment Amount | 7620.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 9884 |
| Number Of Medicare Beneficiaries With Medical Services | 1800 |
| Total Medical Submitted Charge Amount | 1163349 |
| Total Medical Medicare Allowed Amount | 723171.92 |
| Total Medical Medicare Payment Amount | 556641.43 |
| Total Medical Medicare Standardized Payment Amount | 568237.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 296 |
| Number Of Beneficiaries Age 65 to 74 | 632 |
| Number Of Beneficiaries Age 75 to 84 | 557 |
| Number Of Beneficiaries Age Greater 84 | 315 |
| Number Of Female Beneficiaries | 1087 |
| Number Of Male Beneficiaries | 713 |
| Number Of Non Hispanic White Beneficiaries | 1445 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1249 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 551 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8385 |