| National Provider Identifier [NPI]: | 1649229436 |
| Last Name Of The Provider | FREEMAN |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 BARRS ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322044704 |
| 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 | 163 |
| Number Of Services | 5489 |
| Number Of Medicare Beneficiaries | 4054 |
| Total Submitted Charge Amount | 1116572 |
| Total Medicare Allowed Amount | 164297.43 |
| Total Medicare Payment Amount | 120406.08 |
| Total Medicare Standardized Payment Amount | 120277.07 |
| 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 | 163 |
| Number Of Medical Services | 5489 |
| Number Of Medicare Beneficiaries With Medical Services | 4054 |
| Total Medical Submitted Charge Amount | 1116572 |
| Total Medical Medicare Allowed Amount | 164297.43 |
| Total Medical Medicare Payment Amount | 120406.08 |
| Total Medical Medicare Standardized Payment Amount | 120277.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 543 |
| Number Of Beneficiaries Age 65 to 74 | 1549 |
| Number Of Beneficiaries Age 75 to 84 | 1336 |
| Number Of Beneficiaries Age Greater 84 | 626 |
| Number Of Female Beneficiaries | 2465 |
| Number Of Male Beneficiaries | 1589 |
| Number Of Non Hispanic White Beneficiaries | 3163 |
| Number Of Black or African American Beneficiaries | 693 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 778 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.656 |