| National Provider Identifier [NPI]: | 1194897017 |
| Last Name Of The Provider | COVERT |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 860 E FRONT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 496862704 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 13339 |
| Number Of Medicare Beneficiaries | 1096 |
| Total Submitted Charge Amount | 4521246 |
| Total Medicare Allowed Amount | 3490218.8 |
| Total Medicare Payment Amount | 2683823.36 |
| Total Medicare Standardized Payment Amount | 2718752.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5257 |
| Number Of Medicare Beneficiaries With Drug Services | 354 |
| Total Drug Submitted ChargeAmount | 3102506 |
| Total Drug Medicare AllowedAmount | 2704441.74 |
| Total Drug Medicare PaymentAmount | 2105430.16 |
| Total Drug Medicare Standardized Payment Amount | 2105430.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 8082 |
| Number Of Medicare Beneficiaries With Medical Services | 1096 |
| Total Medical Submitted Charge Amount | 1418740 |
| Total Medical Medicare Allowed Amount | 785777.06 |
| Total Medical Medicare Payment Amount | 578393.2 |
| Total Medical Medicare Standardized Payment Amount | 613321.95 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 395 |
| Number Of Beneficiaries Age 75 to 84 | 379 |
| Number Of Beneficiaries Age Greater 84 | 254 |
| Number Of Female Beneficiaries | 613 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 1058 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2963 |