| National Provider Identifier [NPI]: | 1790030906 |
| Last Name Of The Provider | ALLPORT |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 HILLCREST MEDICAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WACO |
| Zip Code Of The Provider | 767128897 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 767 |
| Number Of Medicare Beneficiaries | 570 |
| Total Submitted Charge Amount | 827183 |
| Total Medicare Allowed Amount | 99782.45 |
| Total Medicare Payment Amount | 74810.82 |
| Total Medicare Standardized Payment Amount | 77010.39 |
| 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 | 35 |
| Number Of Medical Services | 767 |
| Number Of Medicare Beneficiaries With Medical Services | 570 |
| Total Medical Submitted Charge Amount | 827183 |
| Total Medical Medicare Allowed Amount | 99782.45 |
| Total Medical Medicare Payment Amount | 74810.82 |
| Total Medical Medicare Standardized Payment Amount | 77010.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 350 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 439 |
| Number Of Black or African American Beneficiaries | 77 |
| 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 | 393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7719 |