| National Provider Identifier [NPI]: | 1730160177 |
| Last Name Of The Provider | BLANKENSHIP |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 OGLETHORPE AVE |
| Street Address 2 Of The Provider | SUITE 2000 |
| City Of The Provider | ATHENS |
| Zip Code Of The Provider | 306062179 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 8819 |
| Number Of Medicare Beneficiaries | 889 |
| Total Submitted Charge Amount | 1170605 |
| Total Medicare Allowed Amount | 383281.03 |
| Total Medicare Payment Amount | 284841.99 |
| Total Medicare Standardized Payment Amount | 302295.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 4254 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 188480 |
| Total Drug Medicare AllowedAmount | 52463.18 |
| Total Drug Medicare PaymentAmount | 40697.47 |
| Total Drug Medicare Standardized Payment Amount | 40697.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 4565 |
| Number Of Medicare Beneficiaries With Medical Services | 889 |
| Total Medical Submitted Charge Amount | 982125 |
| Total Medical Medicare Allowed Amount | 330817.85 |
| Total Medical Medicare Payment Amount | 244144.52 |
| Total Medical Medicare Standardized Payment Amount | 261598.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 384 |
| Number Of Beneficiaries Age 75 to 84 | 273 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 295 |
| Number Of Male Beneficiaries | 594 |
| Number Of Non Hispanic White Beneficiaries | 773 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 728 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3557 |