| National Provider Identifier [NPI]: | 1982629283 |
| Last Name Of The Provider | HOLDER |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3015 NE LOOP 286 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARIS |
| Zip Code Of The Provider | 75460 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 28751.8 |
| Number Of Medicare Beneficiaries | 3275 |
| Total Submitted Charge Amount | 4312135.79 |
| Total Medicare Allowed Amount | 729611.07 |
| Total Medicare Payment Amount | 543282.43 |
| Total Medicare Standardized Payment Amount | 595412.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22726.8 |
| Number Of Medicare Beneficiaries With Drug Services | 331 |
| Total Drug Submitted ChargeAmount | 17609.79 |
| Total Drug Medicare AllowedAmount | 9619.68 |
| Total Drug Medicare PaymentAmount | 7541.29 |
| Total Drug Medicare Standardized Payment Amount | 7541.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 6025 |
| Number Of Medicare Beneficiaries With Medical Services | 3275 |
| Total Medical Submitted Charge Amount | 4294526 |
| Total Medical Medicare Allowed Amount | 719991.39 |
| Total Medical Medicare Payment Amount | 535741.14 |
| Total Medical Medicare Standardized Payment Amount | 587870.93 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 732 |
| Number Of Beneficiaries Age 65 to 74 | 1376 |
| Number Of Beneficiaries Age 75 to 84 | 883 |
| Number Of Beneficiaries Age Greater 84 | 284 |
| Number Of Female Beneficiaries | 2003 |
| Number Of Male Beneficiaries | 1272 |
| Number Of Non Hispanic White Beneficiaries | 2649 |
| Number Of Black or African American Beneficiaries | 519 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2514 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 761 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.269 |