| National Provider Identifier [NPI]: | 1942251376 |
| Last Name Of The Provider | MANNSCHRECK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1254 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 994032841 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 4617 |
| Number Of Medicare Beneficiaries | 2054 |
| Total Submitted Charge Amount | 375312 |
| Total Medicare Allowed Amount | 130351.09 |
| Total Medicare Payment Amount | 104698.56 |
| Total Medicare Standardized Payment Amount | 107045.79 |
| 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 | 182 |
| Number Of Medical Services | 4617 |
| Number Of Medicare Beneficiaries With Medical Services | 2054 |
| Total Medical Submitted Charge Amount | 375312 |
| Total Medical Medicare Allowed Amount | 130351.09 |
| Total Medical Medicare Payment Amount | 104698.56 |
| Total Medical Medicare Standardized Payment Amount | 107045.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 279 |
| Number Of Beneficiaries Age 65 to 74 | 760 |
| Number Of Beneficiaries Age 75 to 84 | 659 |
| Number Of Beneficiaries Age Greater 84 | 356 |
| Number Of Female Beneficiaries | 1249 |
| Number Of Male Beneficiaries | 805 |
| Number Of Non Hispanic White Beneficiaries | 1975 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1642 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 412 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.423 |