| National Provider Identifier [NPI]: | 1023121381 |
| Last Name Of The Provider | DUPRE |
| First Name Of The Provider | CONNIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1657 N EXPRESSWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRIFFIN |
| Zip Code Of The Provider | 302231276 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 8648 |
| Number Of Medicare Beneficiaries | 920 |
| Total Submitted Charge Amount | 292468 |
| Total Medicare Allowed Amount | 196292.35 |
| Total Medicare Payment Amount | 126145.22 |
| Total Medicare Standardized Payment Amount | 145841.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 3204 |
| Number Of Medicare Beneficiaries With Drug Services | 425 |
| Total Drug Submitted ChargeAmount | 33922 |
| Total Drug Medicare AllowedAmount | 7302.44 |
| Total Drug Medicare PaymentAmount | 5874.58 |
| Total Drug Medicare Standardized Payment Amount | 5874.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 5444 |
| Number Of Medicare Beneficiaries With Medical Services | 920 |
| Total Medical Submitted Charge Amount | 258546 |
| Total Medical Medicare Allowed Amount | 188989.91 |
| Total Medical Medicare Payment Amount | 120270.64 |
| Total Medical Medicare Standardized Payment Amount | 139966.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 157 |
| Number Of Beneficiaries Age 65 to 74 | 416 |
| Number Of Beneficiaries Age 75 to 84 | 274 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 571 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 776 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 794 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9681 |