| National Provider Identifier [NPI]: | 1760428478 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 NE MOTHER JOSEPH PL |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | VANCOUVER |
| Zip Code Of The Provider | 986643299 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 1011 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 434022.8 |
| Total Medicare Allowed Amount | 151878.98 |
| Total Medicare Payment Amount | 112854.88 |
| Total Medicare Standardized Payment Amount | 113309.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 9456.21 |
| Total Drug Medicare AllowedAmount | 7189.53 |
| Total Drug Medicare PaymentAmount | 5553.83 |
| Total Drug Medicare Standardized Payment Amount | 5553.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 934 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 424566.59 |
| Total Medical Medicare Allowed Amount | 144689.45 |
| Total Medical Medicare Payment Amount | 107301.05 |
| Total Medical Medicare Standardized Payment Amount | 107755.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | |
| 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 | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8069 |