| National Provider Identifier [NPI]: | 1225267370 |
| Last Name Of The Provider | BLANKENSHIP |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 313 WEST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAINTSVILLE |
| Zip Code Of The Provider | 412401054 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 247 |
| Number Of Medicare Beneficiaries | 85 |
| Total Submitted Charge Amount | 61330 |
| Total Medicare Allowed Amount | 23450.18 |
| Total Medicare Payment Amount | 17971.36 |
| Total Medicare Standardized Payment Amount | 19452.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 325 |
| Total Drug Medicare AllowedAmount | 115.08 |
| Total Drug Medicare PaymentAmount | 90.25 |
| Total Drug Medicare Standardized Payment Amount | 90.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 182 |
| Number Of Medicare Beneficiaries With Medical Services | 85 |
| Total Medical Submitted Charge Amount | 61005 |
| Total Medical Medicare Allowed Amount | 23335.1 |
| Total Medical Medicare Payment Amount | 17881.11 |
| Total Medical Medicare Standardized Payment Amount | 19362.38 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | 85 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2063 |