| National Provider Identifier [NPI]: | 1164416467 |
| Last Name Of The Provider | DOORENBOS |
| First Name Of The Provider | ROY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 4TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRINNELL |
| Zip Code Of The Provider | 501120780 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1986 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 211188 |
| Total Medicare Allowed Amount | 116420.92 |
| Total Medicare Payment Amount | 79482.43 |
| Total Medicare Standardized Payment Amount | 87018.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 4461 |
| Total Drug Medicare AllowedAmount | 2829.13 |
| Total Drug Medicare PaymentAmount | 2764.85 |
| Total Drug Medicare Standardized Payment Amount | 2764.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1893 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 206727 |
| Total Medical Medicare Allowed Amount | 113591.79 |
| Total Medical Medicare Payment Amount | 76717.58 |
| Total Medical Medicare Standardized Payment Amount | 84253.16 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | 431 |
| Number Of Black or African American Beneficiaries | |
| 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 | 324 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1556 |