| National Provider Identifier [NPI]: | 1053459800 |
| Last Name Of The Provider | PAGE |
| First Name Of The Provider | JORDAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1235 E CHEROKEE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658042203 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 6036 |
| Number Of Medicare Beneficiaries | 4155 |
| Total Submitted Charge Amount | 1095717 |
| Total Medicare Allowed Amount | 211602.1 |
| Total Medicare Payment Amount | 160727.18 |
| Total Medicare Standardized Payment Amount | 170414.46 |
| 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 | 142 |
| Number Of Medical Services | 6036 |
| Number Of Medicare Beneficiaries With Medical Services | 4155 |
| Total Medical Submitted Charge Amount | 1095717 |
| Total Medical Medicare Allowed Amount | 211602.1 |
| Total Medical Medicare Payment Amount | 160727.18 |
| Total Medical Medicare Standardized Payment Amount | 170414.46 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1003 |
| Number Of Beneficiaries Age 65 to 74 | 1477 |
| Number Of Beneficiaries Age 75 to 84 | 1096 |
| Number Of Beneficiaries Age Greater 84 | 579 |
| Number Of Female Beneficiaries | 2299 |
| Number Of Male Beneficiaries | 1856 |
| Number Of Non Hispanic White Beneficiaries | 4015 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3055 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1100 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5358 |