| National Provider Identifier [NPI]: | 1639130826 |
| Last Name Of The Provider | WOODWORTH |
| First Name Of The Provider | RANDON |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 W 66TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHFIELD |
| Zip Code Of The Provider | 554232374 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1418 |
| Number Of Medicare Beneficiaries | 237 |
| Total Submitted Charge Amount | 134915 |
| Total Medicare Allowed Amount | 58498.05 |
| Total Medicare Payment Amount | 41834.78 |
| Total Medicare Standardized Payment Amount | 43781.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 3689 |
| Total Drug Medicare AllowedAmount | 1847.78 |
| Total Drug Medicare PaymentAmount | 1758.67 |
| Total Drug Medicare Standardized Payment Amount | 1758.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 1340 |
| Number Of Medicare Beneficiaries With Medical Services | 237 |
| Total Medical Submitted Charge Amount | 131226 |
| Total Medical Medicare Allowed Amount | 56650.27 |
| Total Medical Medicare Payment Amount | 40076.11 |
| Total Medical Medicare Standardized Payment Amount | 42022.69 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 124 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| 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 | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0349 |