| National Provider Identifier [NPI]: | 1447367925 |
| Last Name Of The Provider | ROSE |
| First Name Of The Provider | DONAL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2517 HIGHWAY 180 W |
| Street Address 2 Of The Provider | |
| City Of The Provider | MINERAL WELLS |
| Zip Code Of The Provider | 760678239 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 1881 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 1013325 |
| Total Medicare Allowed Amount | 232828.92 |
| Total Medicare Payment Amount | 174941.04 |
| Total Medicare Standardized Payment Amount | 189409.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 645 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 8865 |
| Total Drug Medicare AllowedAmount | 4175.07 |
| Total Drug Medicare PaymentAmount | 3166.12 |
| Total Drug Medicare Standardized Payment Amount | 3166.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 1236 |
| Number Of Medicare Beneficiaries With Medical Services | 262 |
| Total Medical Submitted Charge Amount | 1004460 |
| Total Medical Medicare Allowed Amount | 228653.85 |
| Total Medical Medicare Payment Amount | 171774.92 |
| Total Medical Medicare Standardized Payment Amount | 186243.16 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| 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 | 170 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.41 |