| National Provider Identifier [NPI]: | 1710960299 |
| Last Name Of The Provider | MACKEY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 ATLANTIC AVENUE |
| Street Address 2 Of The Provider | LONG BEACH MEMORIAL MEDICAL CENTER |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 90806 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 3507 |
| Number Of Medicare Beneficiaries | 1911 |
| Total Submitted Charge Amount | 625163 |
| Total Medicare Allowed Amount | 120118.84 |
| Total Medicare Payment Amount | 84625.53 |
| Total Medicare Standardized Payment Amount | 80468.79 |
| 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 | 137 |
| Number Of Medical Services | 3507 |
| Number Of Medicare Beneficiaries With Medical Services | 1911 |
| Total Medical Submitted Charge Amount | 625163 |
| Total Medical Medicare Allowed Amount | 120118.84 |
| Total Medical Medicare Payment Amount | 84625.53 |
| Total Medical Medicare Standardized Payment Amount | 80468.79 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 285 |
| Number Of Beneficiaries Age 65 to 74 | 557 |
| Number Of Beneficiaries Age 75 to 84 | 622 |
| Number Of Beneficiaries Age Greater 84 | 447 |
| Number Of Female Beneficiaries | 1065 |
| Number Of Male Beneficiaries | 846 |
| Number Of Non Hispanic White Beneficiaries | 912 |
| Number Of Black or African American Beneficiaries | 232 |
| Number Of AsianPacific Islander Beneficiaries | 173 |
| Number Of Hispanic Beneficiaries | 517 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 366 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1545 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4502 |