| National Provider Identifier [NPI]: | 1609877067 |
| Last Name Of The Provider | STOCKEL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10748 RED DAHLIA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODSTOCK |
| Zip Code Of The Provider | 211631430 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 1827 |
| Number Of Medicare Beneficiaries | 1015 |
| Total Submitted Charge Amount | 248070 |
| Total Medicare Allowed Amount | 94337.13 |
| Total Medicare Payment Amount | 71659.02 |
| Total Medicare Standardized Payment Amount | 67124.78 |
| 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 | 96 |
| Number Of Medical Services | 1827 |
| Number Of Medicare Beneficiaries With Medical Services | 1015 |
| Total Medical Submitted Charge Amount | 248070 |
| Total Medical Medicare Allowed Amount | 94337.13 |
| Total Medical Medicare Payment Amount | 71659.02 |
| Total Medical Medicare Standardized Payment Amount | 67124.78 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 298 |
| Number Of Beneficiaries Age 65 to 74 | 304 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 428 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| Number Of Black or African American Beneficiaries | 662 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 622 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.2533 |