| National Provider Identifier [NPI]: | 1619940640 |
| Last Name Of The Provider | DOOLEY |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 MAINE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | QUINCY |
| Zip Code Of The Provider | 623014038 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 11238 |
| Number Of Medicare Beneficiaries | 832 |
| Total Submitted Charge Amount | 1551749.76 |
| Total Medicare Allowed Amount | 348205.93 |
| Total Medicare Payment Amount | 259819.08 |
| Total Medicare Standardized Payment Amount | 266101.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 9021 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 335097.82 |
| Total Drug Medicare AllowedAmount | 103581.98 |
| Total Drug Medicare PaymentAmount | 80334.97 |
| Total Drug Medicare Standardized Payment Amount | 80334.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2217 |
| Number Of Medicare Beneficiaries With Medical Services | 831 |
| Total Medical Submitted Charge Amount | 1216651.94 |
| Total Medical Medicare Allowed Amount | 244623.95 |
| Total Medical Medicare Payment Amount | 179484.11 |
| Total Medical Medicare Standardized Payment Amount | 185766.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 328 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 608 |
| Number Of Non Hispanic White Beneficiaries | 805 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 731 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2192 |