| National Provider Identifier [NPI]: | 1518958370 |
| Last Name Of The Provider | FAHRENHOLZ |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1045 N HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURFREESBORO |
| Zip Code Of The Provider | 371302450 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 19389 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 1666146 |
| Total Medicare Allowed Amount | 602007.55 |
| Total Medicare Payment Amount | 432400.4 |
| Total Medicare Standardized Payment Amount | 430086.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 17881 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1508105 |
| Total Drug Medicare AllowedAmount | 560144.14 |
| Total Drug Medicare PaymentAmount | 401753.87 |
| Total Drug Medicare Standardized Payment Amount | 401753.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1508 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 158041 |
| Total Medical Medicare Allowed Amount | 41863.41 |
| Total Medical Medicare Payment Amount | 30646.53 |
| Total Medical Medicare Standardized Payment Amount | 28333.02 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 138 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 46 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9481 |