| National Provider Identifier [NPI]: | 1629031950 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1300 W COURT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARAGOULD |
| Zip Code Of The Provider | 724504105 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 9799 |
| Number Of Medicare Beneficiaries | 719 |
| Total Submitted Charge Amount | 684297.75 |
| Total Medicare Allowed Amount | 325823.45 |
| Total Medicare Payment Amount | 232226.42 |
| Total Medicare Standardized Payment Amount | 247799.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1013 |
| Number Of Medicare Beneficiaries With Drug Services | 373 |
| Total Drug Submitted ChargeAmount | 19113.75 |
| Total Drug Medicare AllowedAmount | 7571.79 |
| Total Drug Medicare PaymentAmount | 6856.57 |
| Total Drug Medicare Standardized Payment Amount | 6856.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 8786 |
| Number Of Medicare Beneficiaries With Medical Services | 719 |
| Total Medical Submitted Charge Amount | 665184 |
| Total Medical Medicare Allowed Amount | 318251.66 |
| Total Medical Medicare Payment Amount | 225369.85 |
| Total Medical Medicare Standardized Payment Amount | 240942.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 301 |
| Number Of Beneficiaries Age 75 to 84 | 212 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 450 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 592 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0606 |