| National Provider Identifier [NPI]: | 1043360043 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3308 SAMSON WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 681233234 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 4772 |
| Number Of Medicare Beneficiaries | 712 |
| Total Submitted Charge Amount | 563781 |
| Total Medicare Allowed Amount | 269995.31 |
| Total Medicare Payment Amount | 192242.69 |
| Total Medicare Standardized Payment Amount | 207499.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 257 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 10353 |
| Total Drug Medicare AllowedAmount | 5953.48 |
| Total Drug Medicare PaymentAmount | 5754.88 |
| Total Drug Medicare Standardized Payment Amount | 5754.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 4515 |
| Number Of Medicare Beneficiaries With Medical Services | 712 |
| Total Medical Submitted Charge Amount | 553428 |
| Total Medical Medicare Allowed Amount | 264041.83 |
| Total Medical Medicare Payment Amount | 186487.81 |
| Total Medical Medicare Standardized Payment Amount | 201744.86 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 429 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 654 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 612 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3805 |