| National Provider Identifier [NPI]: | 1790707057 |
| Last Name Of The Provider | RIDENOUR |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 52 BERLIN RD |
| Street Address 2 Of The Provider | SUITE 5000 |
| City Of The Provider | CHERRY HILL |
| Zip Code Of The Provider | 080343574 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4193 |
| Number Of Medicare Beneficiaries | 1132 |
| Total Submitted Charge Amount | 338200 |
| Total Medicare Allowed Amount | 287254.98 |
| Total Medicare Payment Amount | 213028.71 |
| Total Medicare Standardized Payment Amount | 200086.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 570 |
| Total Drug Medicare AllowedAmount | 174.14 |
| Total Drug Medicare PaymentAmount | 132.27 |
| Total Drug Medicare Standardized Payment Amount | 132.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 4136 |
| Number Of Medicare Beneficiaries With Medical Services | 1132 |
| Total Medical Submitted Charge Amount | 337630 |
| Total Medical Medicare Allowed Amount | 287080.84 |
| Total Medical Medicare Payment Amount | 212896.44 |
| Total Medical Medicare Standardized Payment Amount | 199954.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 270 |
| Number Of Beneficiaries Age 65 to 74 | 304 |
| Number Of Beneficiaries Age 75 to 84 | 320 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 598 |
| Number Of Male Beneficiaries | 534 |
| Number Of Non Hispanic White Beneficiaries | 970 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 740 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 392 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.454 |