| National Provider Identifier [NPI]: | 1437123809 |
| Last Name Of The Provider | SKINNER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| 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 | 116 |
| Number Of Services | 6064 |
| Number Of Medicare Beneficiaries | 2358 |
| Total Submitted Charge Amount | 195009.63 |
| Total Medicare Allowed Amount | 138938.13 |
| Total Medicare Payment Amount | 100437.69 |
| Total Medicare Standardized Payment Amount | 111143.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1122 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 1145.66 |
| Total Drug Medicare AllowedAmount | 1044.8 |
| Total Drug Medicare PaymentAmount | 634.69 |
| Total Drug Medicare Standardized Payment Amount | 634.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 4942 |
| Number Of Medicare Beneficiaries With Medical Services | 2358 |
| Total Medical Submitted Charge Amount | 193863.97 |
| Total Medical Medicare Allowed Amount | 137893.33 |
| Total Medical Medicare Payment Amount | 99803 |
| Total Medical Medicare Standardized Payment Amount | 110509.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 385 |
| Number Of Beneficiaries Age 65 to 74 | 946 |
| Number Of Beneficiaries Age 75 to 84 | 744 |
| Number Of Beneficiaries Age Greater 84 | 283 |
| Number Of Female Beneficiaries | 1299 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 2238 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 323 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5366 |