| National Provider Identifier [NPI]: | 1043269459 |
| Last Name Of The Provider | WOODWORTH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 CHESTNUT HILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STAFFORD SPRINGS |
| Zip Code Of The Provider | 06076 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 5654 |
| Number Of Medicare Beneficiaries | 547 |
| Total Submitted Charge Amount | 425474 |
| Total Medicare Allowed Amount | 142759.17 |
| Total Medicare Payment Amount | 106443.27 |
| Total Medicare Standardized Payment Amount | 110142.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4146 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 102701 |
| Total Drug Medicare AllowedAmount | 65105.6 |
| Total Drug Medicare PaymentAmount | 49662.87 |
| Total Drug Medicare Standardized Payment Amount | 49662.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1508 |
| Number Of Medicare Beneficiaries With Medical Services | 547 |
| Total Medical Submitted Charge Amount | 322773 |
| Total Medical Medicare Allowed Amount | 77653.57 |
| Total Medical Medicare Payment Amount | 56780.4 |
| Total Medical Medicare Standardized Payment Amount | 60479.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 221 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 342 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0503 |