| National Provider Identifier [NPI]: | 1760452783 |
| Last Name Of The Provider | RANGE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4222 FAIRBANKS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAKWOOD |
| Zip Code Of The Provider | 305662811 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 8800 |
| Number Of Medicare Beneficiaries | 520 |
| Total Submitted Charge Amount | 530577 |
| Total Medicare Allowed Amount | 227411.78 |
| Total Medicare Payment Amount | 176361.48 |
| Total Medicare Standardized Payment Amount | 188118.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 2513 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 15312 |
| Total Drug Medicare AllowedAmount | 4717.97 |
| Total Drug Medicare PaymentAmount | 4035.83 |
| Total Drug Medicare Standardized Payment Amount | 4035.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 6287 |
| Number Of Medicare Beneficiaries With Medical Services | 520 |
| Total Medical Submitted Charge Amount | 515265 |
| Total Medical Medicare Allowed Amount | 222693.81 |
| Total Medical Medicare Payment Amount | 172325.65 |
| Total Medical Medicare Standardized Payment Amount | 184082.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 264 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 502 |
| 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 | 464 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0527 |