| National Provider Identifier [NPI]: | 1679681357 |
| Last Name Of The Provider | JOHN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11671 JOLLYVILLE RD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787594139 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 629 |
| Number Of Medicare Beneficiaries | 146 |
| Total Submitted Charge Amount | 73679.78 |
| Total Medicare Allowed Amount | 42711.32 |
| Total Medicare Payment Amount | 31799.37 |
| Total Medicare Standardized Payment Amount | 34375.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 83 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 1675 |
| Total Drug Medicare AllowedAmount | 749.29 |
| Total Drug Medicare PaymentAmount | 706.59 |
| Total Drug Medicare Standardized Payment Amount | 706.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 546 |
| Number Of Medicare Beneficiaries With Medical Services | 146 |
| Total Medical Submitted Charge Amount | 72004.78 |
| Total Medical Medicare Allowed Amount | 41962.03 |
| Total Medical Medicare Payment Amount | 31092.78 |
| Total Medical Medicare Standardized Payment Amount | 33669.25 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 92 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7001 |