| National Provider Identifier [NPI]: | 1699854257 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3100 CHANNING WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | IDAHO FALLS |
| Zip Code Of The Provider | 834047533 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 5683 |
| Number Of Medicare Beneficiaries | 2306 |
| Total Submitted Charge Amount | 374035.41 |
| Total Medicare Allowed Amount | 122371.79 |
| Total Medicare Payment Amount | 97075.98 |
| Total Medicare Standardized Payment Amount | 105183.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2329 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2509 |
| Total Drug Medicare AllowedAmount | 923.6 |
| Total Drug Medicare PaymentAmount | 707.07 |
| Total Drug Medicare Standardized Payment Amount | 707.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 3354 |
| Number Of Medicare Beneficiaries With Medical Services | 2306 |
| Total Medical Submitted Charge Amount | 371526.41 |
| Total Medical Medicare Allowed Amount | 121448.19 |
| Total Medical Medicare Payment Amount | 96368.91 |
| Total Medical Medicare Standardized Payment Amount | 104476.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 881 |
| Number Of Beneficiaries Age 75 to 84 | 698 |
| Number Of Beneficiaries Age Greater 84 | 312 |
| Number Of Female Beneficiaries | 1505 |
| Number Of Male Beneficiaries | 801 |
| Number Of Non Hispanic White Beneficiaries | 2161 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1740 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2713 |