National Provider Identifier [NPI]: |
1164407755 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3739 HIXSON PIKE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
37415 |
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 |
75 |
Number Of Services |
6859 |
Number Of Medicare Beneficiaries |
565 |
Total Submitted Charge Amount |
528385 |
Total Medicare Allowed Amount |
231460.61 |
Total Medicare Payment Amount |
172490.19 |
Total Medicare Standardized Payment Amount |
185172.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
504 |
Number Of Medicare Beneficiaries With Drug Services |
214 |
Total Drug Submitted ChargeAmount |
19456 |
Total Drug Medicare AllowedAmount |
6978.32 |
Total Drug Medicare PaymentAmount |
6451.19 |
Total Drug Medicare Standardized Payment Amount |
6451.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
6355 |
Number Of Medicare Beneficiaries With Medical Services |
565 |
Total Medical Submitted Charge Amount |
508929 |
Total Medical Medicare Allowed Amount |
224482.29 |
Total Medical Medicare Payment Amount |
166039 |
Total Medical Medicare Standardized Payment Amount |
178721.51 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
275 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
269 |
Number Of Non Hispanic White Beneficiaries |
522 |
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 |
543 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.8958 |