| National Provider Identifier [NPI]: | 1962492074 |
| Last Name Of The Provider | SQUIRES |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| 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 | 184 |
| Number Of Services | 34496 |
| Number Of Medicare Beneficiaries | 3460 |
| Total Submitted Charge Amount | 1699560.67 |
| Total Medicare Allowed Amount | 414621.72 |
| Total Medicare Payment Amount | 316234.13 |
| Total Medicare Standardized Payment Amount | 327990.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 29583 |
| Number Of Medicare Beneficiaries With Drug Services | 328 |
| Total Drug Submitted ChargeAmount | 70458.9 |
| Total Drug Medicare AllowedAmount | 7817.25 |
| Total Drug Medicare PaymentAmount | 6000.74 |
| Total Drug Medicare Standardized Payment Amount | 6000.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 4913 |
| Number Of Medicare Beneficiaries With Medical Services | 3456 |
| Total Medical Submitted Charge Amount | 1629101.77 |
| Total Medical Medicare Allowed Amount | 406804.47 |
| Total Medical Medicare Payment Amount | 310233.39 |
| Total Medical Medicare Standardized Payment Amount | 321989.5 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 417 |
| Number Of Beneficiaries Age 65 to 74 | 1139 |
| Number Of Beneficiaries Age 75 to 84 | 1121 |
| Number Of Beneficiaries Age Greater 84 | 783 |
| Number Of Female Beneficiaries | 2136 |
| Number Of Male Beneficiaries | 1324 |
| Number Of Non Hispanic White Beneficiaries | 3188 |
| Number Of Black or African American Beneficiaries | 99 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 106 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2823 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 637 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.852 |