| National Provider Identifier [NPI]: | 1750599742 |
| Last Name Of The Provider | BLACKMON |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 DAN PROCTOR DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT MARYS |
| Zip Code Of The Provider | 315583810 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 7366 |
| Number Of Medicare Beneficiaries | 3800 |
| Total Submitted Charge Amount | 848662 |
| Total Medicare Allowed Amount | 214601.82 |
| Total Medicare Payment Amount | 166329.08 |
| Total Medicare Standardized Payment Amount | 173969.28 |
| 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 | 195 |
| Number Of Medical Services | 7366 |
| Number Of Medicare Beneficiaries With Medical Services | 3800 |
| Total Medical Submitted Charge Amount | 848662 |
| Total Medical Medicare Allowed Amount | 214601.82 |
| Total Medical Medicare Payment Amount | 166329.08 |
| Total Medical Medicare Standardized Payment Amount | 173969.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 973 |
| Number Of Beneficiaries Age 65 to 74 | 1407 |
| Number Of Beneficiaries Age 75 to 84 | 968 |
| Number Of Beneficiaries Age Greater 84 | 452 |
| Number Of Female Beneficiaries | 2444 |
| Number Of Male Beneficiaries | 1356 |
| Number Of Non Hispanic White Beneficiaries | 3099 |
| Number Of Black or African American Beneficiaries | 602 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2590 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1210 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4818 |