| National Provider Identifier [NPI]: | 1538140322 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1409 E LAKE MEAD BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH LAS VEGAS |
| Zip Code Of The Provider | 890307120 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 8860 |
| Number Of Medicare Beneficiaries | 2496 |
| Total Submitted Charge Amount | 1469350.94 |
| Total Medicare Allowed Amount | 314038.95 |
| Total Medicare Payment Amount | 235550.59 |
| Total Medicare Standardized Payment Amount | 235295.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4799 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 8582 |
| Total Drug Medicare AllowedAmount | 1577.61 |
| Total Drug Medicare PaymentAmount | 1222.38 |
| Total Drug Medicare Standardized Payment Amount | 1222.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 4061 |
| Number Of Medicare Beneficiaries With Medical Services | 2496 |
| Total Medical Submitted Charge Amount | 1460768.94 |
| Total Medical Medicare Allowed Amount | 312461.34 |
| Total Medical Medicare Payment Amount | 234328.21 |
| Total Medical Medicare Standardized Payment Amount | 234073.25 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 595 |
| Number Of Beneficiaries Age 65 to 74 | 894 |
| Number Of Beneficiaries Age 75 to 84 | 674 |
| Number Of Beneficiaries Age Greater 84 | 333 |
| Number Of Female Beneficiaries | 1490 |
| Number Of Male Beneficiaries | 1006 |
| Number Of Non Hispanic White Beneficiaries | 2118 |
| Number Of Black or African American Beneficiaries | 185 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 738 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4877 |