| National Provider Identifier [NPI]: | 1265472138 |
| Last Name Of The Provider | ROTHROCK |
| 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 | 804 AINSWORTH DR |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863011624 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5469 |
| Number Of Medicare Beneficiaries | 1446 |
| Total Submitted Charge Amount | 1190701.74 |
| Total Medicare Allowed Amount | 573947.48 |
| Total Medicare Payment Amount | 428218.14 |
| Total Medicare Standardized Payment Amount | 436508.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 25048 |
| Total Drug Medicare AllowedAmount | 6565.5 |
| Total Drug Medicare PaymentAmount | 5032.1 |
| Total Drug Medicare Standardized Payment Amount | 5032.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 5345 |
| Number Of Medicare Beneficiaries With Medical Services | 1446 |
| Total Medical Submitted Charge Amount | 1165653.74 |
| Total Medical Medicare Allowed Amount | 567381.98 |
| Total Medical Medicare Payment Amount | 423186.04 |
| Total Medical Medicare Standardized Payment Amount | 431476.53 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 554 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 675 |
| Number Of Male Beneficiaries | 771 |
| Number Of Non Hispanic White Beneficiaries | 1383 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.274 |