| National Provider Identifier [NPI]: | 1396719696 |
| Last Name Of The Provider | DALBA |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 SW ARCHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326103003 |
| 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 | 85 |
| Number Of Services | 9161 |
| Number Of Medicare Beneficiaries | 3873 |
| Total Submitted Charge Amount | 1148037 |
| Total Medicare Allowed Amount | 566825.92 |
| Total Medicare Payment Amount | 498804.18 |
| Total Medicare Standardized Payment Amount | 511882.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1902 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 3804 |
| Total Drug Medicare AllowedAmount | 401.11 |
| Total Drug Medicare PaymentAmount | 314.49 |
| Total Drug Medicare Standardized Payment Amount | 314.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 7259 |
| Number Of Medicare Beneficiaries With Medical Services | 3873 |
| Total Medical Submitted Charge Amount | 1144233 |
| Total Medical Medicare Allowed Amount | 566424.81 |
| Total Medical Medicare Payment Amount | 498489.69 |
| Total Medical Medicare Standardized Payment Amount | 511567.52 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 437 |
| Number Of Beneficiaries Age 65 to 74 | 1979 |
| Number Of Beneficiaries Age 75 to 84 | 1134 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 3314 |
| Number Of Male Beneficiaries | 559 |
| Number Of Non Hispanic White Beneficiaries | 3258 |
| Number Of Black or African American Beneficiaries | 473 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 615 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.081 |