| National Provider Identifier [NPI]: | 1316942253 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5296 PETERS CREEK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240193808 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 15533 |
| Number Of Medicare Beneficiaries | 1278 |
| Total Submitted Charge Amount | 6291705 |
| Total Medicare Allowed Amount | 5021789.24 |
| Total Medicare Payment Amount | 3890347.3 |
| Total Medicare Standardized Payment Amount | 3901131.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6424 |
| Number Of Medicare Beneficiaries With Drug Services | 474 |
| Total Drug Submitted ChargeAmount | 4454749 |
| Total Drug Medicare AllowedAmount | 4020890.08 |
| Total Drug Medicare PaymentAmount | 3148081.75 |
| Total Drug Medicare Standardized Payment Amount | 3148081.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 9109 |
| Number Of Medicare Beneficiaries With Medical Services | 1278 |
| Total Medical Submitted Charge Amount | 1836956 |
| Total Medical Medicare Allowed Amount | 1000899.16 |
| Total Medical Medicare Payment Amount | 742265.55 |
| Total Medical Medicare Standardized Payment Amount | 753050.05 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 413 |
| Number Of Beneficiaries Age Greater 84 | 366 |
| Number Of Female Beneficiaries | 784 |
| Number Of Male Beneficiaries | 494 |
| Number Of Non Hispanic White Beneficiaries | 1187 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1130 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4081 |