| National Provider Identifier [NPI]: | 1952368557 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1218 S BROADWAY |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | LEXINGTON |
| Zip Code Of The Provider | 405042759 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 204 |
| Number Of Services | 10512 |
| Number Of Medicare Beneficiaries | 6537 |
| Total Submitted Charge Amount | 1328327 |
| Total Medicare Allowed Amount | 283463.79 |
| Total Medicare Payment Amount | 210454.4 |
| Total Medicare Standardized Payment Amount | 219944.34 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1876 |
| Number Of Beneficiaries Age 65 to 74 | 2177 |
| Number Of Beneficiaries Age 75 to 84 | 1632 |
| Number Of Beneficiaries Age Greater 84 | 852 |
| Number Of Female Beneficiaries | 3894 |
| Number Of Male Beneficiaries | 2643 |
| Number Of Non Hispanic White Beneficiaries | 6137 |
| Number Of Black or African American Beneficiaries | 324 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2696 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7786 |