| National Provider Identifier [NPI]: | 1124005145 |
| Last Name Of The Provider | ALTENBERN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 395 WALLACE RD |
| Street Address 2 Of The Provider | STE 206B |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372114881 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 4219 |
| Number Of Medicare Beneficiaries | 433 |
| Total Submitted Charge Amount | 431738.5 |
| Total Medicare Allowed Amount | 170705.48 |
| Total Medicare Payment Amount | 129023.05 |
| Total Medicare Standardized Payment Amount | 136414.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1391 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 69435.5 |
| Total Drug Medicare AllowedAmount | 38169.43 |
| Total Drug Medicare PaymentAmount | 29835.17 |
| Total Drug Medicare Standardized Payment Amount | 29835.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 2828 |
| Number Of Medicare Beneficiaries With Medical Services | 433 |
| Total Medical Submitted Charge Amount | 362303 |
| Total Medical Medicare Allowed Amount | 132536.05 |
| Total Medical Medicare Payment Amount | 99187.88 |
| Total Medical Medicare Standardized Payment Amount | 106579.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 189 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 357 |
| Number Of Black or African American Beneficiaries | 60 |
| 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 | 348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3895 |