| National Provider Identifier [NPI]: | 1629295738 |
| Last Name Of The Provider | DUNNEBACKE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 587 SKYLINE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383013911 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 4361 |
| Number Of Medicare Beneficiaries | 2014 |
| Total Submitted Charge Amount | 392962.5 |
| Total Medicare Allowed Amount | 177424.79 |
| Total Medicare Payment Amount | 119510.15 |
| Total Medicare Standardized Payment Amount | 132070.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 518 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 10958.5 |
| Total Drug Medicare AllowedAmount | 3743.76 |
| Total Drug Medicare PaymentAmount | 2977.15 |
| Total Drug Medicare Standardized Payment Amount | 2977.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3843 |
| Number Of Medicare Beneficiaries With Medical Services | 2014 |
| Total Medical Submitted Charge Amount | 382004 |
| Total Medical Medicare Allowed Amount | 173681.03 |
| Total Medical Medicare Payment Amount | 116533 |
| Total Medical Medicare Standardized Payment Amount | 129093.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 449 |
| Number Of Beneficiaries Age 65 to 74 | 805 |
| Number Of Beneficiaries Age 75 to 84 | 558 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 1081 |
| Number Of Male Beneficiaries | 933 |
| Number Of Non Hispanic White Beneficiaries | 1668 |
| Number Of Black or African American Beneficiaries | 319 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 552 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6745 |