| National Provider Identifier [NPI]: | 1669531836 |
| Last Name Of The Provider | STALLWORTH |
| 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 | 1112 E WEISGARBER RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379092647 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 7467 |
| Number Of Medicare Beneficiaries | 4391 |
| Total Submitted Charge Amount | 750151 |
| Total Medicare Allowed Amount | 205321.49 |
| Total Medicare Payment Amount | 159536.95 |
| Total Medicare Standardized Payment Amount | 170466.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 7467 |
| Number Of Medicare Beneficiaries With Medical Services | 4391 |
| Total Medical Submitted Charge Amount | 750151 |
| Total Medical Medicare Allowed Amount | 205321.49 |
| Total Medical Medicare Payment Amount | 159536.95 |
| Total Medical Medicare Standardized Payment Amount | 170466.99 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1043 |
| Number Of Beneficiaries Age 65 to 74 | 1776 |
| Number Of Beneficiaries Age 75 to 84 | 1101 |
| Number Of Beneficiaries Age Greater 84 | 471 |
| Number Of Female Beneficiaries | 2755 |
| Number Of Male Beneficiaries | 1636 |
| Number Of Non Hispanic White Beneficiaries | 4242 |
| Number Of Black or African American Beneficiaries | 88 |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2776 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1615 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.457 |