| National Provider Identifier [NPI]: | 1659486587 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10060 REGENCY CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681143732 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 8821 |
| Number Of Medicare Beneficiaries | 1567 |
| Total Submitted Charge Amount | 1007771.95 |
| Total Medicare Allowed Amount | 367406.11 |
| Total Medicare Payment Amount | 258826.59 |
| Total Medicare Standardized Payment Amount | 278991.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 98 |
| Total Drug Medicare AllowedAmount | 87.36 |
| Total Drug Medicare PaymentAmount | 64.87 |
| Total Drug Medicare Standardized Payment Amount | 64.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 8772 |
| Number Of Medicare Beneficiaries With Medical Services | 1567 |
| Total Medical Submitted Charge Amount | 1007673.95 |
| Total Medical Medicare Allowed Amount | 367318.75 |
| Total Medical Medicare Payment Amount | 258761.72 |
| Total Medical Medicare Standardized Payment Amount | 278926.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 724 |
| Number Of Beneficiaries Age 75 to 84 | 544 |
| Number Of Beneficiaries Age Greater 84 | 253 |
| Number Of Female Beneficiaries | 715 |
| Number Of Male Beneficiaries | 852 |
| Number Of Non Hispanic White Beneficiaries | 1538 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1515 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9086 |