| National Provider Identifier [NPI]: | 1356456446 |
| Last Name Of The Provider | CULBERSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2002 HOLCOMBE BLVD |
| Street Address 2 Of The Provider | MAIL STATION110 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770304211 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 187 |
| Number Of Medicare Beneficiaries | 82 |
| Total Submitted Charge Amount | 18961.12 |
| Total Medicare Allowed Amount | 11529.15 |
| Total Medicare Payment Amount | 8614.03 |
| Total Medicare Standardized Payment Amount | 9279.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 987.12 |
| Total Drug Medicare AllowedAmount | 412.96 |
| Total Drug Medicare PaymentAmount | 403.66 |
| Total Drug Medicare Standardized Payment Amount | 403.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 162 |
| Number Of Medicare Beneficiaries With Medical Services | 82 |
| Total Medical Submitted Charge Amount | 17974 |
| Total Medical Medicare Allowed Amount | 11116.19 |
| Total Medical Medicare Payment Amount | 8210.37 |
| Total Medical Medicare Standardized Payment Amount | 8875.48 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | 58 |
| Number Of Black or African American Beneficiaries | |
| 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 | 54 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2769 |