| National Provider Identifier [NPI]: | 1164473005 |
| Last Name Of The Provider | JERNIGAN |
| First Name Of The Provider | PERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 SUNSET DR |
| Street Address 2 Of The Provider | STE 3 |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376047906 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 8253 |
| Number Of Medicare Beneficiaries | 4468 |
| Total Submitted Charge Amount | 754796 |
| Total Medicare Allowed Amount | 198487.7 |
| Total Medicare Payment Amount | 145759.58 |
| Total Medicare Standardized Payment Amount | 156849.06 |
| 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 | 178 |
| Number Of Medical Services | 8253 |
| Number Of Medicare Beneficiaries With Medical Services | 4468 |
| Total Medical Submitted Charge Amount | 754796 |
| Total Medical Medicare Allowed Amount | 198487.7 |
| Total Medical Medicare Payment Amount | 145759.58 |
| Total Medical Medicare Standardized Payment Amount | 156849.06 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 967 |
| Number Of Beneficiaries Age 65 to 74 | 1515 |
| Number Of Beneficiaries Age 75 to 84 | 1315 |
| Number Of Beneficiaries Age Greater 84 | 671 |
| Number Of Female Beneficiaries | 2477 |
| Number Of Male Beneficiaries | 1991 |
| Number Of Non Hispanic White Beneficiaries | 4339 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1567 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8551 |