| National Provider Identifier [NPI]: | 1376534453 |
| Last Name Of The Provider | KARSTAEDT |
| First Name Of The Provider | NOLAN |
| 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 | 90 |
| Number Of Services | 101082 |
| Number Of Medicare Beneficiaries | 2955 |
| Total Submitted Charge Amount | 680485.43 |
| Total Medicare Allowed Amount | 443452.1 |
| Total Medicare Payment Amount | 328249.09 |
| Total Medicare Standardized Payment Amount | 389418 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 96379 |
| Number Of Medicare Beneficiaries With Drug Services | 620 |
| Total Drug Submitted ChargeAmount | 27942.75 |
| Total Drug Medicare AllowedAmount | 18227.35 |
| Total Drug Medicare PaymentAmount | 12520.73 |
| Total Drug Medicare Standardized Payment Amount | 12520.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 4703 |
| Number Of Medicare Beneficiaries With Medical Services | 2941 |
| Total Medical Submitted Charge Amount | 652542.68 |
| Total Medical Medicare Allowed Amount | 425224.75 |
| Total Medical Medicare Payment Amount | 315728.36 |
| Total Medical Medicare Standardized Payment Amount | 376897.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 458 |
| Number Of Beneficiaries Age 65 to 74 | 1203 |
| Number Of Beneficiaries Age 75 to 84 | 911 |
| Number Of Beneficiaries Age Greater 84 | 383 |
| Number Of Female Beneficiaries | 1432 |
| Number Of Male Beneficiaries | 1523 |
| Number Of Non Hispanic White Beneficiaries | 2530 |
| Number Of Black or African American Beneficiaries | 252 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0599 |