| National Provider Identifier [NPI]: | 1447255229 |
| Last Name Of The Provider | DECAPRIO |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5002 COWHORN CREEK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755039766 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 8406 |
| Number Of Medicare Beneficiaries | 1338 |
| Total Submitted Charge Amount | 2573900.07 |
| Total Medicare Allowed Amount | 919792.95 |
| Total Medicare Payment Amount | 698367.9 |
| Total Medicare Standardized Payment Amount | 750807.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4424 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 7205.2 |
| Total Drug Medicare AllowedAmount | 986.71 |
| Total Drug Medicare PaymentAmount | 755.09 |
| Total Drug Medicare Standardized Payment Amount | 755.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 3982 |
| Number Of Medicare Beneficiaries With Medical Services | 1338 |
| Total Medical Submitted Charge Amount | 2566694.87 |
| Total Medical Medicare Allowed Amount | 918806.24 |
| Total Medical Medicare Payment Amount | 697612.81 |
| Total Medical Medicare Standardized Payment Amount | 750051.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 531 |
| Number Of Beneficiaries Age 75 to 84 | 455 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 717 |
| Number Of Male Beneficiaries | 621 |
| Number Of Non Hispanic White Beneficiaries | 1019 |
| Number Of Black or African American Beneficiaries | 277 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 983 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 355 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2189 |