| National Provider Identifier [NPI]: | 1780846204 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | KARDELINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1912 HAMILTON ST STE 201 |
| Street Address 2 Of The Provider | DRS. MCCLOW, CLARK AND BERK, P.A. |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322102078 |
| 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 | 144 |
| Number Of Services | 2973 |
| Number Of Medicare Beneficiaries | 2110 |
| Total Submitted Charge Amount | 707521 |
| Total Medicare Allowed Amount | 103278.8 |
| Total Medicare Payment Amount | 80357.28 |
| Total Medicare Standardized Payment Amount | 80174.67 |
| 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 | 144 |
| Number Of Medical Services | 2973 |
| Number Of Medicare Beneficiaries With Medical Services | 2110 |
| Total Medical Submitted Charge Amount | 707521 |
| Total Medical Medicare Allowed Amount | 103278.8 |
| Total Medical Medicare Payment Amount | 80357.28 |
| Total Medical Medicare Standardized Payment Amount | 80174.67 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 387 |
| Number Of Beneficiaries Age 65 to 74 | 741 |
| Number Of Beneficiaries Age 75 to 84 | 634 |
| Number Of Beneficiaries Age Greater 84 | 348 |
| Number Of Female Beneficiaries | 1256 |
| Number Of Male Beneficiaries | 854 |
| Number Of Non Hispanic White Beneficiaries | 1620 |
| Number Of Black or African American Beneficiaries | 379 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.856 |