| National Provider Identifier [NPI]: | 1073504940 |
| Last Name Of The Provider | WOLDEHER |
| First Name Of The Provider | GETACHEW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2712 JEFFERSON DAVIS HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | STAFFORD |
| Zip Code Of The Provider | 225541733 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1234 |
| Number Of Medicare Beneficiaries | 385 |
| Total Submitted Charge Amount | 197868 |
| Total Medicare Allowed Amount | 118986.08 |
| Total Medicare Payment Amount | 88265.61 |
| Total Medicare Standardized Payment Amount | 83970.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 452 |
| Total Drug Medicare AllowedAmount | 129.61 |
| Total Drug Medicare PaymentAmount | 122.18 |
| Total Drug Medicare Standardized Payment Amount | 122.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1211 |
| Number Of Medicare Beneficiaries With Medical Services | 385 |
| Total Medical Submitted Charge Amount | 197416 |
| Total Medical Medicare Allowed Amount | 118856.47 |
| Total Medical Medicare Payment Amount | 88143.43 |
| Total Medical Medicare Standardized Payment Amount | 83848.38 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 208 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 240 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9245 |