| National Provider Identifier [NPI]: | 1447365846 |
| Last Name Of The Provider | ELLZEY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6019 WALNUT GROVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| 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 | 193 |
| Number Of Services | 8193 |
| Number Of Medicare Beneficiaries | 5122 |
| Total Submitted Charge Amount | 850507 |
| Total Medicare Allowed Amount | 213028.18 |
| Total Medicare Payment Amount | 161742.32 |
| Total Medicare Standardized Payment Amount | 173133.92 |
| 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 | 193 |
| Number Of Medical Services | 8193 |
| Number Of Medicare Beneficiaries With Medical Services | 5122 |
| Total Medical Submitted Charge Amount | 850507 |
| Total Medical Medicare Allowed Amount | 213028.18 |
| Total Medical Medicare Payment Amount | 161742.32 |
| Total Medical Medicare Standardized Payment Amount | 173133.92 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1001 |
| Number Of Beneficiaries Age 65 to 74 | 1790 |
| Number Of Beneficiaries Age 75 to 84 | 1513 |
| Number Of Beneficiaries Age Greater 84 | 818 |
| Number Of Female Beneficiaries | 3020 |
| Number Of Male Beneficiaries | 2102 |
| Number Of Non Hispanic White Beneficiaries | 3715 |
| Number Of Black or African American Beneficiaries | 1319 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3706 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1416 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1481 |