| National Provider Identifier [NPI]: | 1659376416 |
| Last Name Of The Provider | MACDOUGALL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 224 CIRCLE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 496842342 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2708 |
| Number Of Medicare Beneficiaries | 304 |
| Total Submitted Charge Amount | 141250.75 |
| Total Medicare Allowed Amount | 102261.2 |
| Total Medicare Payment Amount | 74105.32 |
| Total Medicare Standardized Payment Amount | 76882.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 1993.6 |
| Total Drug Medicare AllowedAmount | 1688.67 |
| Total Drug Medicare PaymentAmount | 1653.84 |
| Total Drug Medicare Standardized Payment Amount | 1653.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2624 |
| Number Of Medicare Beneficiaries With Medical Services | 304 |
| Total Medical Submitted Charge Amount | 139257.15 |
| Total Medical Medicare Allowed Amount | 100572.53 |
| Total Medical Medicare Payment Amount | 72451.48 |
| Total Medical Medicare Standardized Payment Amount | 75228.8 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9873 |