| National Provider Identifier [NPI]: | 1649388612 |
| Last Name Of The Provider | DOUGLAS |
| First Name Of The Provider | MEGAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 538 WINTHROP ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | REHOBOTH |
| Zip Code Of The Provider | 027691227 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 477 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 45322 |
| Total Medicare Allowed Amount | 23344.35 |
| Total Medicare Payment Amount | 16079.54 |
| Total Medicare Standardized Payment Amount | 15839.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1783 |
| Total Drug Medicare AllowedAmount | 1293.16 |
| Total Drug Medicare PaymentAmount | 1260.65 |
| Total Drug Medicare Standardized Payment Amount | 1260.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 437 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 43539 |
| Total Medical Medicare Allowed Amount | 22051.19 |
| Total Medical Medicare Payment Amount | 14818.89 |
| Total Medical Medicare Standardized Payment Amount | 14578.42 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 19 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.95 |