| National Provider Identifier [NPI]: | 1891786984 |
| Last Name Of The Provider | PAZ-FUMAGALLI |
| First Name Of The Provider | RICARDO |
| 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 | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| 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 | 214 |
| Number Of Services | 15357 |
| Number Of Medicare Beneficiaries | 863 |
| Total Submitted Charge Amount | 423911.83 |
| Total Medicare Allowed Amount | 269746.66 |
| Total Medicare Payment Amount | 201921 |
| Total Medicare Standardized Payment Amount | 219280.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 13310 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 5103.33 |
| Total Drug Medicare AllowedAmount | 3303.78 |
| Total Drug Medicare PaymentAmount | 2329.65 |
| Total Drug Medicare Standardized Payment Amount | 2329.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 207 |
| Number Of Medical Services | 2047 |
| Number Of Medicare Beneficiaries With Medical Services | 847 |
| Total Medical Submitted Charge Amount | 418808.5 |
| Total Medical Medicare Allowed Amount | 266442.88 |
| Total Medical Medicare Payment Amount | 199591.35 |
| Total Medical Medicare Standardized Payment Amount | 216950.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 258 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 487 |
| Number Of Non Hispanic White Beneficiaries | 731 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 783 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.6123 |