| National Provider Identifier [NPI]: | 1477711919 |
| Last Name Of The Provider | CAUGHRON |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAWRENCEVILLE |
| Zip Code Of The Provider | 300467694 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 273 |
| Number Of Services | 6769 |
| Number Of Medicare Beneficiaries | 3473 |
| Total Submitted Charge Amount | 1067325 |
| Total Medicare Allowed Amount | 249100.27 |
| Total Medicare Payment Amount | 190492.29 |
| Total Medicare Standardized Payment Amount | 200805.27 |
| 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 | 273 |
| Number Of Medical Services | 6769 |
| Number Of Medicare Beneficiaries With Medical Services | 3473 |
| Total Medical Submitted Charge Amount | 1067325 |
| Total Medical Medicare Allowed Amount | 249100.27 |
| Total Medical Medicare Payment Amount | 190492.29 |
| Total Medical Medicare Standardized Payment Amount | 200805.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 513 |
| Number Of Beneficiaries Age 65 to 74 | 1459 |
| Number Of Beneficiaries Age 75 to 84 | 1066 |
| Number Of Beneficiaries Age Greater 84 | 435 |
| Number Of Female Beneficiaries | 2102 |
| Number Of Male Beneficiaries | 1371 |
| Number Of Non Hispanic White Beneficiaries | 3017 |
| Number Of Black or African American Beneficiaries | 371 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2808 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 665 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5608 |