| National Provider Identifier [NPI]: | 1073775466 |
| Last Name Of The Provider | OLIVER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 LAKEVIEW DR |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 390564430 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 4739 |
| Number Of Medicare Beneficiaries | 1657 |
| Total Submitted Charge Amount | 334239 |
| Total Medicare Allowed Amount | 115077.06 |
| Total Medicare Payment Amount | 88920.42 |
| Total Medicare Standardized Payment Amount | 95531.89 |
| 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 | 147 |
| Number Of Medical Services | 4739 |
| Number Of Medicare Beneficiaries With Medical Services | 1657 |
| Total Medical Submitted Charge Amount | 334239 |
| Total Medical Medicare Allowed Amount | 115077.06 |
| Total Medical Medicare Payment Amount | 88920.42 |
| Total Medical Medicare Standardized Payment Amount | 95531.89 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 449 |
| Number Of Beneficiaries Age 65 to 74 | 580 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 1061 |
| Number Of Male Beneficiaries | 596 |
| Number Of Non Hispanic White Beneficiaries | 830 |
| Number Of Black or African American Beneficiaries | 810 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 836 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3732 |