| National Provider Identifier [NPI]: | 1790721819 |
| Last Name Of The Provider | JUSTICE |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 80 VERMONT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK RIDGE |
| Zip Code Of The Provider | 378306474 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 7410 |
| Number Of Medicare Beneficiaries | 1917 |
| Total Submitted Charge Amount | 1007037.58 |
| Total Medicare Allowed Amount | 506996.23 |
| Total Medicare Payment Amount | 377429.71 |
| Total Medicare Standardized Payment Amount | 408294.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 333 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 18296.32 |
| Total Drug Medicare AllowedAmount | 17610.14 |
| Total Drug Medicare PaymentAmount | 13681.9 |
| Total Drug Medicare Standardized Payment Amount | 13681.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 7077 |
| Number Of Medicare Beneficiaries With Medical Services | 1917 |
| Total Medical Submitted Charge Amount | 988741.26 |
| Total Medical Medicare Allowed Amount | 489386.09 |
| Total Medical Medicare Payment Amount | 363747.81 |
| Total Medical Medicare Standardized Payment Amount | 394612.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 330 |
| Number Of Beneficiaries Age 65 to 74 | 657 |
| Number Of Beneficiaries Age 75 to 84 | 589 |
| Number Of Beneficiaries Age Greater 84 | 341 |
| Number Of Female Beneficiaries | 974 |
| Number Of Male Beneficiaries | 943 |
| Number Of Non Hispanic White Beneficiaries | 1856 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 1409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 508 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7256 |