| National Provider Identifier [NPI]: | 1417995663 |
| Last Name Of The Provider | MORRISON |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 MEDICAL WAY |
| Street Address 2 Of The Provider | EASTSIDE MEDICAL CENTER |
| City Of The Provider | SNELLVILEL |
| Zip Code Of The Provider | 30278 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1380 |
| Number Of Medicare Beneficiaries | 1112 |
| Total Submitted Charge Amount | 936894 |
| Total Medicare Allowed Amount | 205663.56 |
| Total Medicare Payment Amount | 158310.88 |
| Total Medicare Standardized Payment Amount | 162689.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1380 |
| Number Of Medicare Beneficiaries With Medical Services | 1112 |
| Total Medical Submitted Charge Amount | 936894 |
| Total Medical Medicare Allowed Amount | 205663.56 |
| Total Medical Medicare Payment Amount | 158310.88 |
| Total Medical Medicare Standardized Payment Amount | 162689.55 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 239 |
| Number Of Beneficiaries Age 65 to 74 | 340 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 186 |
| Number Of Female Beneficiaries | 654 |
| Number Of Male Beneficiaries | 458 |
| Number Of Non Hispanic White Beneficiaries | 987 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0738 |