| National Provider Identifier [NPI]: | 1124267778 |
| Last Name Of The Provider | PUCKETT |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 JESSE JEWELL PKWY |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 30501 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 5713 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 1415981.98 |
| Total Medicare Allowed Amount | 389131.5 |
| Total Medicare Payment Amount | 290460.74 |
| Total Medicare Standardized Payment Amount | 313013.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2041 |
| Number Of Medicare Beneficiaries With Drug Services | 341 |
| Total Drug Submitted ChargeAmount | 103466 |
| Total Drug Medicare AllowedAmount | 56934.72 |
| Total Drug Medicare PaymentAmount | 44456.41 |
| Total Drug Medicare Standardized Payment Amount | 44456.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 3672 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 1312515.98 |
| Total Medical Medicare Allowed Amount | 332196.78 |
| Total Medical Medicare Payment Amount | 246004.33 |
| Total Medical Medicare Standardized Payment Amount | 268557.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 701 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 629 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0703 |