| National Provider Identifier [NPI]: | 1285756163 |
| Last Name Of The Provider | HARRELL |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 DOCTORS DRIVE |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | DOUGLAS |
| Zip Code Of The Provider | 315332203 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 2770 |
| Number Of Medicare Beneficiaries | 917 |
| Total Submitted Charge Amount | 1311406.6 |
| Total Medicare Allowed Amount | 216798.67 |
| Total Medicare Payment Amount | 160155.45 |
| Total Medicare Standardized Payment Amount | 168147.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 445 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 15156 |
| Total Drug Medicare AllowedAmount | 4335.21 |
| Total Drug Medicare PaymentAmount | 3534.76 |
| Total Drug Medicare Standardized Payment Amount | 3534.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 2325 |
| Number Of Medicare Beneficiaries With Medical Services | 917 |
| Total Medical Submitted Charge Amount | 1296250.6 |
| Total Medical Medicare Allowed Amount | 212463.46 |
| Total Medical Medicare Payment Amount | 156620.69 |
| Total Medical Medicare Standardized Payment Amount | 164612.48 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 311 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 405 |
| Number Of Non Hispanic White Beneficiaries | 705 |
| Number Of Black or African American Beneficiaries | 196 |
| 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 | 526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 391 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7602 |