| National Provider Identifier [NPI]: | 1538115621 |
| Last Name Of The Provider | IRWIN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 94 MARIE LANGDON DR |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 409626353 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 811 |
| Number Of Medicare Beneficiaries | 616 |
| Total Submitted Charge Amount | 837047 |
| Total Medicare Allowed Amount | 108745.13 |
| Total Medicare Payment Amount | 82041.81 |
| Total Medicare Standardized Payment Amount | 84987.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 811 |
| Number Of Medicare Beneficiaries With Medical Services | 616 |
| Total Medical Submitted Charge Amount | 837047 |
| Total Medical Medicare Allowed Amount | 108745.13 |
| Total Medical Medicare Payment Amount | 82041.81 |
| Total Medical Medicare Standardized Payment Amount | 84987.63 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 367 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 573 |
| Number Of Black or African American Beneficiaries | 32 |
| 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 | 334 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 282 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5923 |