National Provider Identifier [NPI]: |
1720013428 |
Last Name Of The Provider |
WOFFORD |
First Name Of The Provider |
MARION |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 NORTH STATE STREET |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE/DIVISION OF GENERAL INTERNAL MED |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164500 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1124 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
187200 |
Total Medicare Allowed Amount |
95757.48 |
Total Medicare Payment Amount |
64617.34 |
Total Medicare Standardized Payment Amount |
70931.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
1792 |
Total Drug Medicare AllowedAmount |
757.94 |
Total Drug Medicare PaymentAmount |
742.79 |
Total Drug Medicare Standardized Payment Amount |
742.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1083 |
Number Of Medicare Beneficiaries With Medical Services |
526 |
Total Medical Submitted Charge Amount |
185408 |
Total Medical Medicare Allowed Amount |
94999.54 |
Total Medical Medicare Payment Amount |
63874.55 |
Total Medical Medicare Standardized Payment Amount |
70188.44 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
335 |
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 |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5243 |