| National Provider Identifier [NPI]: | 1649229063 |
| Last Name Of The Provider | GRATZ |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3599 UNIVERSITY BLVD S |
| Street Address 2 Of The Provider | BUILDING 300 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322164252 |
| 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 | 156 |
| Number Of Services | 6500 |
| Number Of Medicare Beneficiaries | 4743 |
| Total Submitted Charge Amount | 784774 |
| Total Medicare Allowed Amount | 190726.07 |
| Total Medicare Payment Amount | 146245.71 |
| Total Medicare Standardized Payment Amount | 146390.24 |
| 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 | 156 |
| Number Of Medical Services | 6500 |
| Number Of Medicare Beneficiaries With Medical Services | 4743 |
| Total Medical Submitted Charge Amount | 784774 |
| Total Medical Medicare Allowed Amount | 190726.07 |
| Total Medical Medicare Payment Amount | 146245.71 |
| Total Medical Medicare Standardized Payment Amount | 146390.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 829 |
| Number Of Beneficiaries Age 65 to 74 | 1931 |
| Number Of Beneficiaries Age 75 to 84 | 1284 |
| Number Of Beneficiaries Age Greater 84 | 699 |
| Number Of Female Beneficiaries | 2988 |
| Number Of Male Beneficiaries | 1755 |
| Number Of Non Hispanic White Beneficiaries | 3837 |
| Number Of Black or African American Beneficiaries | 666 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1113 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8903 |