| National Provider Identifier [NPI]: | 1265454474 |
| Last Name Of The Provider | ACKERMANN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 ABRAHAM FLEXNER WAY |
| Street Address 2 Of The Provider | PATHOLOGY DEPT |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402021818 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2927 |
| Number Of Medicare Beneficiaries | 1129 |
| Total Submitted Charge Amount | 534134 |
| Total Medicare Allowed Amount | 109227 |
| Total Medicare Payment Amount | 84842.36 |
| Total Medicare Standardized Payment Amount | 62759.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 2927 |
| Number Of Medicare Beneficiaries With Medical Services | 1129 |
| Total Medical Submitted Charge Amount | 534134 |
| Total Medical Medicare Allowed Amount | 109227 |
| Total Medical Medicare Payment Amount | 84842.36 |
| Total Medical Medicare Standardized Payment Amount | 62759.34 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 485 |
| Number Of Beneficiaries Age 75 to 84 | 258 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 631 |
| Number Of Male Beneficiaries | 498 |
| Number Of Non Hispanic White Beneficiaries | 945 |
| Number Of Black or African American Beneficiaries | 144 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 838 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 291 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8359 |