| National Provider Identifier [NPI]: | 1720056237 |
| Last Name Of The Provider | REGISTRE |
| First Name Of The Provider | LOUIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1697 KINGS RD |
| Street Address 2 Of The Provider | UFJP COLLEGE PARK FAMILY PRACTICE CENTER |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322096169 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1663 |
| Number Of Medicare Beneficiaries | 296 |
| Total Submitted Charge Amount | 177343 |
| Total Medicare Allowed Amount | 92640.05 |
| Total Medicare Payment Amount | 60752.45 |
| Total Medicare Standardized Payment Amount | 61470.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 98 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 4065 |
| Total Drug Medicare AllowedAmount | 2200.37 |
| Total Drug Medicare PaymentAmount | 2154.94 |
| Total Drug Medicare Standardized Payment Amount | 2154.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 1565 |
| Number Of Medicare Beneficiaries With Medical Services | 296 |
| Total Medical Submitted Charge Amount | 173278 |
| Total Medical Medicare Allowed Amount | 90439.68 |
| Total Medical Medicare Payment Amount | 58597.51 |
| Total Medical Medicare Standardized Payment Amount | 59315.64 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 268 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5036 |