| National Provider Identifier [NPI]: | 1124064639 |
| Last Name Of The Provider | TRUBIANO |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 342 JEFFERSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TILTONSVILLE |
| Zip Code Of The Provider | 439631058 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 410 |
| Number Of Medicare Beneficiaries | 172 |
| Total Submitted Charge Amount | 42351 |
| Total Medicare Allowed Amount | 27843.52 |
| Total Medicare Payment Amount | 17414.88 |
| Total Medicare Standardized Payment Amount | 18130.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 603 |
| Total Drug Medicare AllowedAmount | 86.5 |
| Total Drug Medicare PaymentAmount | 68.78 |
| Total Drug Medicare Standardized Payment Amount | 68.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 368 |
| Number Of Medicare Beneficiaries With Medical Services | 172 |
| Total Medical Submitted Charge Amount | 41748 |
| Total Medical Medicare Allowed Amount | 27757.02 |
| Total Medical Medicare Payment Amount | 17346.1 |
| Total Medical Medicare Standardized Payment Amount | 18061.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8745 |