| National Provider Identifier [NPI]: | 1427050632 |
| Last Name Of The Provider | STOUT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1602 VERNON RD |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | LAGRANGE |
| Zip Code Of The Provider | 302404100 |
| 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 | 123 |
| Number Of Services | 21490 |
| Number Of Medicare Beneficiaries | 852 |
| Total Submitted Charge Amount | 1085287.88 |
| Total Medicare Allowed Amount | 608381.23 |
| Total Medicare Payment Amount | 505277.63 |
| Total Medicare Standardized Payment Amount | 528740.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1072 |
| Number Of Medicare Beneficiaries With Drug Services | 439 |
| Total Drug Submitted ChargeAmount | 41136 |
| Total Drug Medicare AllowedAmount | 36237.84 |
| Total Drug Medicare PaymentAmount | 34982.28 |
| Total Drug Medicare Standardized Payment Amount | 34982.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 20418 |
| Number Of Medicare Beneficiaries With Medical Services | 852 |
| Total Medical Submitted Charge Amount | 1044151.88 |
| Total Medical Medicare Allowed Amount | 572143.39 |
| Total Medical Medicare Payment Amount | 470295.35 |
| Total Medical Medicare Standardized Payment Amount | 493758.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 527 |
| Number Of Male Beneficiaries | 325 |
| Number Of Non Hispanic White Beneficiaries | 756 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 713 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0347 |