| National Provider Identifier [NPI]: | 1003889577 |
| Last Name Of The Provider | YOUNG |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2845 SIENA HEIGHTS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HENDERSON |
| Zip Code Of The Provider | 890524153 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 151 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 19276 |
| Total Medicare Allowed Amount | 7289.17 |
| Total Medicare Payment Amount | 4377.45 |
| Total Medicare Standardized Payment Amount | 5242.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 176 |
| Total Drug Medicare AllowedAmount | 39.98 |
| Total Drug Medicare PaymentAmount | 25.01 |
| Total Drug Medicare Standardized Payment Amount | 25.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 132 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 19100 |
| Total Medical Medicare Allowed Amount | 7249.19 |
| Total Medical Medicare Payment Amount | 4352.44 |
| Total Medical Medicare Standardized Payment Amount | 5217.65 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | 41 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2996 |