| National Provider Identifier [NPI]: | 1235172529 |
| Last Name Of The Provider | MATTEO |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 W 8TH ST |
| Street Address 2 Of The Provider | UFJP RADIOLOGY |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322096511 |
| 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 | 141 |
| Number Of Services | 1296 |
| Number Of Medicare Beneficiaries | 532 |
| Total Submitted Charge Amount | 861729 |
| Total Medicare Allowed Amount | 121970.72 |
| Total Medicare Payment Amount | 93530.24 |
| Total Medicare Standardized Payment Amount | 92105.26 |
| 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 | 141 |
| Number Of Medical Services | 1296 |
| Number Of Medicare Beneficiaries With Medical Services | 532 |
| Total Medical Submitted Charge Amount | 861729 |
| Total Medical Medicare Allowed Amount | 121970.72 |
| Total Medical Medicare Payment Amount | 93530.24 |
| Total Medical Medicare Standardized Payment Amount | 92105.26 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 258 |
| Number Of Non Hispanic White Beneficiaries | 234 |
| Number Of Black or African American Beneficiaries | 277 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 343 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 3.3089 |