| National Provider Identifier [NPI]: | 1487662888 |
| Last Name Of The Provider | MCGIRR |
| First Name Of The Provider | DOUGLAS |
| 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 | 1121 W VINE STREET |
| Street Address 2 Of The Provider | SUITE 15 |
| City Of The Provider | LODI |
| Zip Code Of The Provider | 95240 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 15388 |
| Number Of Medicare Beneficiaries | 1506 |
| Total Submitted Charge Amount | 769264.6 |
| Total Medicare Allowed Amount | 232638.72 |
| Total Medicare Payment Amount | 171374.76 |
| Total Medicare Standardized Payment Amount | 163749.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 13120 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 26240 |
| Total Drug Medicare AllowedAmount | 2383.04 |
| Total Drug Medicare PaymentAmount | 1660.22 |
| Total Drug Medicare Standardized Payment Amount | 1660.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 2268 |
| Number Of Medicare Beneficiaries With Medical Services | 1506 |
| Total Medical Submitted Charge Amount | 743024.6 |
| Total Medical Medicare Allowed Amount | 230255.68 |
| Total Medical Medicare Payment Amount | 169714.54 |
| Total Medical Medicare Standardized Payment Amount | 162088.98 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 602 |
| Number Of Beneficiaries Age 75 to 84 | 418 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 816 |
| Number Of Male Beneficiaries | 690 |
| Number Of Non Hispanic White Beneficiaries | 636 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | 268 |
| Number Of Hispanic Beneficiaries | 377 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 735 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3681 |