| National Provider Identifier [NPI]: | 1568405496 |
| Last Name Of The Provider | NAVERSEN |
| First Name Of The Provider | DOUGLAS |
| 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 | 2959 SISKIYOU BLVD |
| Street Address 2 Of The Provider | #B |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975048131 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 9790 |
| Number Of Medicare Beneficiaries | 1547 |
| Total Submitted Charge Amount | 617106.13 |
| Total Medicare Allowed Amount | 552130.48 |
| Total Medicare Payment Amount | 396027.17 |
| Total Medicare Standardized Payment Amount | 400229.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 527 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 5934.08 |
| Total Drug Medicare AllowedAmount | 5249.99 |
| Total Drug Medicare PaymentAmount | 3999.14 |
| Total Drug Medicare Standardized Payment Amount | 3999.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 9263 |
| Number Of Medicare Beneficiaries With Medical Services | 1547 |
| Total Medical Submitted Charge Amount | 611172.05 |
| Total Medical Medicare Allowed Amount | 546880.49 |
| Total Medical Medicare Payment Amount | 392028.03 |
| Total Medical Medicare Standardized Payment Amount | 396230.76 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 795 |
| Number Of Beneficiaries Age 75 to 84 | 503 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 777 |
| Number Of Male Beneficiaries | 770 |
| Number Of Non Hispanic White Beneficiaries | 1494 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8571 |