| National Provider Identifier [NPI]: | 1841342912 |
| Last Name Of The Provider | OTT |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 DAIRY ASHFORD ST |
| Street Address 2 Of The Provider | #118 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770793023 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1433 |
| Number Of Medicare Beneficiaries | 465 |
| Total Submitted Charge Amount | 143890.84 |
| Total Medicare Allowed Amount | 99151.32 |
| Total Medicare Payment Amount | 68002.97 |
| Total Medicare Standardized Payment Amount | 67522.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 225.84 |
| Total Drug Medicare AllowedAmount | 17.31 |
| Total Drug Medicare PaymentAmount | 6.86 |
| Total Drug Medicare Standardized Payment Amount | 6.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1365 |
| Number Of Medicare Beneficiaries With Medical Services | 465 |
| Total Medical Submitted Charge Amount | 143665 |
| Total Medical Medicare Allowed Amount | 99134.01 |
| Total Medical Medicare Payment Amount | 67996.11 |
| Total Medical Medicare Standardized Payment Amount | 67515.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 225 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 267 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 407 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 451 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8894 |