| National Provider Identifier [NPI]: | 1205814803 |
| Last Name Of The Provider | OBRAY |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 652 S MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 84790 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 9054.2 |
| Number Of Medicare Beneficiaries | 1131 |
| Total Submitted Charge Amount | 2333822.28 |
| Total Medicare Allowed Amount | 748248.14 |
| Total Medicare Payment Amount | 570909.71 |
| Total Medicare Standardized Payment Amount | 590529.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3650.2 |
| Number Of Medicare Beneficiaries With Drug Services | 525 |
| Total Drug Submitted ChargeAmount | 43717.2 |
| Total Drug Medicare AllowedAmount | 8167.21 |
| Total Drug Medicare PaymentAmount | 6319.04 |
| Total Drug Medicare Standardized Payment Amount | 6319.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5404 |
| Number Of Medicare Beneficiaries With Medical Services | 1131 |
| Total Medical Submitted Charge Amount | 2290105.08 |
| Total Medical Medicare Allowed Amount | 740080.93 |
| Total Medical Medicare Payment Amount | 564590.67 |
| Total Medical Medicare Standardized Payment Amount | 584210.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 492 |
| Number Of Non Hispanic White Beneficiaries | 1086 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1021 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2659 |