| National Provider Identifier [NPI]: | 1588635684 |
| Last Name Of The Provider | FUGITT |
| First Name Of The Provider | JONATHAN |
| 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 | 315 HOLTON AVE |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | YAKIMA |
| Zip Code Of The Provider | 989023254 |
| 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 | 184 |
| Number Of Services | 9518 |
| Number Of Medicare Beneficiaries | 5043 |
| Total Submitted Charge Amount | 1633361.7 |
| Total Medicare Allowed Amount | 633714.22 |
| Total Medicare Payment Amount | 480816.37 |
| Total Medicare Standardized Payment Amount | 471719.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1934 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 2482 |
| Total Drug Medicare AllowedAmount | 490.31 |
| Total Drug Medicare PaymentAmount | 384.38 |
| Total Drug Medicare Standardized Payment Amount | 384.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 7584 |
| Number Of Medicare Beneficiaries With Medical Services | 5043 |
| Total Medical Submitted Charge Amount | 1630879.7 |
| Total Medical Medicare Allowed Amount | 633223.91 |
| Total Medical Medicare Payment Amount | 480431.99 |
| Total Medical Medicare Standardized Payment Amount | 471334.73 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1233 |
| Number Of Beneficiaries Age 65 to 74 | 1912 |
| Number Of Beneficiaries Age 75 to 84 | 1323 |
| Number Of Beneficiaries Age Greater 84 | 575 |
| Number Of Female Beneficiaries | 2966 |
| Number Of Male Beneficiaries | 2077 |
| Number Of Non Hispanic White Beneficiaries | 4579 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | 177 |
| Number Of American Indian Alaska Native Beneficiaries | 129 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1722 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4032 |