| National Provider Identifier [NPI]: | 1790930899 |
| Last Name Of The Provider | HIGGINBOTHAM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12221 MERIT DRIVE |
| Street Address 2 Of The Provider | SUITE 1500 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 75251 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1428 |
| Number Of Medicare Beneficiaries | 468 |
| Total Submitted Charge Amount | 543210 |
| Total Medicare Allowed Amount | 162434.48 |
| Total Medicare Payment Amount | 124810.16 |
| Total Medicare Standardized Payment Amount | 129551.85 |
| 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 | 18 |
| Number Of Medical Services | 1428 |
| Number Of Medicare Beneficiaries With Medical Services | 468 |
| Total Medical Submitted Charge Amount | 543210 |
| Total Medical Medicare Allowed Amount | 162434.48 |
| Total Medical Medicare Payment Amount | 124810.16 |
| Total Medical Medicare Standardized Payment Amount | 129551.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 189 |
| Number Of Non Hispanic White Beneficiaries | 408 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 299 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3121 |