| National Provider Identifier [NPI]: | 1619961570 |
| Last Name Of The Provider | EDWARDS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3417 ENSIGN RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065064 |
| 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 | 163 |
| Number Of Services | 3714 |
| Number Of Medicare Beneficiaries | 2011 |
| Total Submitted Charge Amount | 382677.57 |
| Total Medicare Allowed Amount | 128197.13 |
| Total Medicare Payment Amount | 96726.68 |
| Total Medicare Standardized Payment Amount | 99634.4 |
| 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 | 163 |
| Number Of Medical Services | 3714 |
| Number Of Medicare Beneficiaries With Medical Services | 2011 |
| Total Medical Submitted Charge Amount | 382677.57 |
| Total Medical Medicare Allowed Amount | 128197.13 |
| Total Medical Medicare Payment Amount | 96726.68 |
| Total Medical Medicare Standardized Payment Amount | 99634.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 638 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 1148 |
| Number Of Male Beneficiaries | 863 |
| Number Of Non Hispanic White Beneficiaries | 1899 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 27 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 607 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4694 |