| National Provider Identifier [NPI]: | 1164470621 |
| Last Name Of The Provider | SHILL |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| 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 | 222 |
| Number Of Services | 13045 |
| Number Of Medicare Beneficiaries | 5262 |
| Total Submitted Charge Amount | 902518.41 |
| Total Medicare Allowed Amount | 287877.4 |
| Total Medicare Payment Amount | 216184.82 |
| Total Medicare Standardized Payment Amount | 218561.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6010 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 2924.73 |
| Total Drug Medicare AllowedAmount | 1315.75 |
| Total Drug Medicare PaymentAmount | 1007.28 |
| Total Drug Medicare Standardized Payment Amount | 1007.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 220 |
| Number Of Medical Services | 7035 |
| Number Of Medicare Beneficiaries With Medical Services | 5258 |
| Total Medical Submitted Charge Amount | 899593.68 |
| Total Medical Medicare Allowed Amount | 286561.65 |
| Total Medical Medicare Payment Amount | 215177.54 |
| Total Medical Medicare Standardized Payment Amount | 217553.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 850 |
| Number Of Beneficiaries Age 65 to 74 | 1793 |
| Number Of Beneficiaries Age 75 to 84 | 1595 |
| Number Of Beneficiaries Age Greater 84 | 1024 |
| Number Of Female Beneficiaries | 2853 |
| Number Of Male Beneficiaries | 2409 |
| Number Of Non Hispanic White Beneficiaries | 3870 |
| Number Of Black or African American Beneficiaries | 553 |
| Number Of AsianPacific Islander Beneficiaries | 73 |
| Number Of Hispanic Beneficiaries | 693 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3874 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1388 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2837 |