| National Provider Identifier [NPI]: | 1295711257 |
| Last Name Of The Provider | HUSTON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 4179 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 179438.71 |
| Total Medicare Allowed Amount | 84815.37 |
| Total Medicare Payment Amount | 61727.28 |
| Total Medicare Standardized Payment Amount | 71294.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3727 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 4283.49 |
| Total Drug Medicare AllowedAmount | 3422.69 |
| Total Drug Medicare PaymentAmount | 2016.73 |
| Total Drug Medicare Standardized Payment Amount | 2016.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 452 |
| Number Of Medicare Beneficiaries With Medical Services | 323 |
| Total Medical Submitted Charge Amount | 175155.22 |
| Total Medical Medicare Allowed Amount | 81392.68 |
| Total Medical Medicare Payment Amount | 59710.55 |
| Total Medical Medicare Standardized Payment Amount | 69277.31 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 307 |
| 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 | 282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.402 |