National Provider Identifier [NPI]: |
1558448423 |
Last Name Of The Provider |
WOLOHON |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1608 WILLIAMS DR. |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
37129 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
3527 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
272723.5 |
Total Medicare Allowed Amount |
147822.5 |
Total Medicare Payment Amount |
112013.05 |
Total Medicare Standardized Payment Amount |
121236.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
182 |
Number Of Medicare Beneficiaries With Drug Services |
155 |
Total Drug Submitted ChargeAmount |
8638.2 |
Total Drug Medicare AllowedAmount |
5530.69 |
Total Drug Medicare PaymentAmount |
5414.28 |
Total Drug Medicare Standardized Payment Amount |
5414.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
3345 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
264085.3 |
Total Medical Medicare Allowed Amount |
142291.81 |
Total Medical Medicare Payment Amount |
106598.77 |
Total Medical Medicare Standardized Payment Amount |
115822.28 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
286 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9567 |