| National Provider Identifier [NPI]: | 1033171335 |
| Last Name Of The Provider | ANDREW |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1901 MEDIPARK |
| Street Address 2 Of The Provider | STE 2050 |
| City Of The Provider | AMARILLO |
| Zip Code Of The Provider | 79106 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 214 |
| Number Of Services | 5308 |
| Number Of Medicare Beneficiaries | 2852 |
| Total Submitted Charge Amount | 1106432.17 |
| Total Medicare Allowed Amount | 219905.87 |
| Total Medicare Payment Amount | 168193.4 |
| Total Medicare Standardized Payment Amount | 179842.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1170 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 4662 |
| Total Drug Medicare AllowedAmount | 1193.27 |
| Total Drug Medicare PaymentAmount | 894.28 |
| Total Drug Medicare Standardized Payment Amount | 894.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 212 |
| Number Of Medical Services | 4138 |
| Number Of Medicare Beneficiaries With Medical Services | 2851 |
| Total Medical Submitted Charge Amount | 1101770.17 |
| Total Medical Medicare Allowed Amount | 218712.6 |
| Total Medical Medicare Payment Amount | 167299.12 |
| Total Medical Medicare Standardized Payment Amount | 178948.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 402 |
| Number Of Beneficiaries Age 65 to 74 | 969 |
| Number Of Beneficiaries Age 75 to 84 | 958 |
| Number Of Beneficiaries Age Greater 84 | 523 |
| Number Of Female Beneficiaries | 1711 |
| Number Of Male Beneficiaries | 1141 |
| Number Of Non Hispanic White Beneficiaries | 2355 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 392 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2223 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 629 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6361 |