| National Provider Identifier [NPI]: | 1609840685 |
| Last Name Of The Provider | STATLER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 SAM PERRY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224014453 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 263 |
| Number Of Services | 42243 |
| Number Of Medicare Beneficiaries | 3165 |
| Total Submitted Charge Amount | 2960390.34 |
| Total Medicare Allowed Amount | 512806.55 |
| Total Medicare Payment Amount | 389072.47 |
| Total Medicare Standardized Payment Amount | 404072.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 37005 |
| Number Of Medicare Beneficiaries With Drug Services | 365 |
| Total Drug Submitted ChargeAmount | 91326.25 |
| Total Drug Medicare AllowedAmount | 6838.79 |
| Total Drug Medicare PaymentAmount | 4988.78 |
| Total Drug Medicare Standardized Payment Amount | 4988.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 261 |
| Number Of Medical Services | 5238 |
| Number Of Medicare Beneficiaries With Medical Services | 3164 |
| Total Medical Submitted Charge Amount | 2869064.09 |
| Total Medical Medicare Allowed Amount | 505967.76 |
| Total Medical Medicare Payment Amount | 384083.69 |
| Total Medical Medicare Standardized Payment Amount | 399083.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 414 |
| Number Of Beneficiaries Age 65 to 74 | 1322 |
| Number Of Beneficiaries Age 75 to 84 | 1037 |
| Number Of Beneficiaries Age Greater 84 | 392 |
| Number Of Female Beneficiaries | 1720 |
| Number Of Male Beneficiaries | 1445 |
| Number Of Non Hispanic White Beneficiaries | 2563 |
| Number Of Black or African American Beneficiaries | 480 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 483 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7497 |