| National Provider Identifier [NPI]: | 1306844121 |
| Last Name Of The Provider | PERRY |
| 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 | 89 INTERCHANGE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND HILL |
| Zip Code Of The Provider | 313247661 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 10394 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 607308 |
| Total Medicare Allowed Amount | 245763.06 |
| Total Medicare Payment Amount | 195635.95 |
| Total Medicare Standardized Payment Amount | 206274.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2059 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 45247 |
| Total Drug Medicare AllowedAmount | 15668.3 |
| Total Drug Medicare PaymentAmount | 13872.39 |
| Total Drug Medicare Standardized Payment Amount | 13872.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 8335 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 562061 |
| Total Medical Medicare Allowed Amount | 230094.76 |
| Total Medical Medicare Payment Amount | 181763.56 |
| Total Medical Medicare Standardized Payment Amount | 192401.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | 356 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0053 |