| National Provider Identifier [NPI]: | 1093716631 |
| Last Name Of The Provider | TRIPPE |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5508 SUMMERHILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755031822 |
| 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 | 200 |
| Number Of Services | 23567 |
| Number Of Medicare Beneficiaries | 4406 |
| Total Submitted Charge Amount | 1558610.49 |
| Total Medicare Allowed Amount | 354989.14 |
| Total Medicare Payment Amount | 262487.26 |
| Total Medicare Standardized Payment Amount | 281961.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 14634 |
| Number Of Medicare Beneficiaries With Drug Services | 186 |
| Total Drug Submitted ChargeAmount | 18539 |
| Total Drug Medicare AllowedAmount | 3896.26 |
| Total Drug Medicare PaymentAmount | 3015.33 |
| Total Drug Medicare Standardized Payment Amount | 3015.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 8933 |
| Number Of Medicare Beneficiaries With Medical Services | 4405 |
| Total Medical Submitted Charge Amount | 1540071.49 |
| Total Medical Medicare Allowed Amount | 351092.88 |
| Total Medical Medicare Payment Amount | 259471.93 |
| Total Medical Medicare Standardized Payment Amount | 278945.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 995 |
| Number Of Beneficiaries Age 65 to 74 | 1705 |
| Number Of Beneficiaries Age 75 to 84 | 1162 |
| Number Of Beneficiaries Age Greater 84 | 544 |
| Number Of Female Beneficiaries | 2833 |
| Number Of Male Beneficiaries | 1573 |
| Number Of Non Hispanic White Beneficiaries | 3382 |
| Number Of Black or African American Beneficiaries | 936 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 27 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2926 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1480 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.4885 |