| National Provider Identifier [NPI]: | 1497931406 |
| Last Name Of The Provider | CARROLL |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 734 N 3RD ST |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347485285 |
| 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 | 223 |
| Number Of Services | 36313 |
| Number Of Medicare Beneficiaries | 7212 |
| Total Submitted Charge Amount | 2102755 |
| Total Medicare Allowed Amount | 932509.59 |
| Total Medicare Payment Amount | 721424.51 |
| Total Medicare Standardized Payment Amount | 738409.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 25461 |
| Number Of Medicare Beneficiaries With Drug Services | 781 |
| Total Drug Submitted ChargeAmount | 123228 |
| Total Drug Medicare AllowedAmount | 19943.83 |
| Total Drug Medicare PaymentAmount | 15618.41 |
| Total Drug Medicare Standardized Payment Amount | 15618.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 215 |
| Number Of Medical Services | 10852 |
| Number Of Medicare Beneficiaries With Medical Services | 7178 |
| Total Medical Submitted Charge Amount | 1979527 |
| Total Medical Medicare Allowed Amount | 912565.76 |
| Total Medical Medicare Payment Amount | 705806.1 |
| Total Medical Medicare Standardized Payment Amount | 722791.5 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 423 |
| Number Of Beneficiaries Age 65 to 74 | 3068 |
| Number Of Beneficiaries Age 75 to 84 | 2699 |
| Number Of Beneficiaries Age Greater 84 | 1022 |
| Number Of Female Beneficiaries | 4069 |
| Number Of Male Beneficiaries | 3143 |
| Number Of Non Hispanic White Beneficiaries | 6783 |
| Number Of Black or African American Beneficiaries | 233 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 664 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5365 |