| National Provider Identifier [NPI]: | 1104856475 |
| Last Name Of The Provider | CUNNINGHAM |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4350 N 19TH AVE |
| Street Address 2 Of The Provider | SUITE 6 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850154602 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 8735 |
| Number Of Medicare Beneficiaries | 634 |
| Total Submitted Charge Amount | 534536.4 |
| Total Medicare Allowed Amount | 391184.36 |
| Total Medicare Payment Amount | 278849.81 |
| Total Medicare Standardized Payment Amount | 283491.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 2480 |
| Number Of Medicare Beneficiaries With Drug Services | 371 |
| Total Drug Submitted ChargeAmount | 24995.4 |
| Total Drug Medicare AllowedAmount | 14202.41 |
| Total Drug Medicare PaymentAmount | 13192.28 |
| Total Drug Medicare Standardized Payment Amount | 13192.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 6255 |
| Number Of Medicare Beneficiaries With Medical Services | 634 |
| Total Medical Submitted Charge Amount | 509541 |
| Total Medical Medicare Allowed Amount | 376981.95 |
| Total Medical Medicare Payment Amount | 265657.53 |
| Total Medical Medicare Standardized Payment Amount | 270299.71 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 291 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 330 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 373 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2607 |