| National Provider Identifier [NPI]: | 1679678205 |
| Last Name Of The Provider | WOMACK |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 JOY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MOHAVE |
| Zip Code Of The Provider | 864268807 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 5833 |
| Number Of Medicare Beneficiaries | 918 |
| Total Submitted Charge Amount | 503137 |
| Total Medicare Allowed Amount | 398090.01 |
| Total Medicare Payment Amount | 282247.79 |
| Total Medicare Standardized Payment Amount | 288321.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 274 |
| Number Of Medicare Beneficiaries With Drug Services | 198 |
| Total Drug Submitted ChargeAmount | 6900 |
| Total Drug Medicare AllowedAmount | 3983.13 |
| Total Drug Medicare PaymentAmount | 3863.68 |
| Total Drug Medicare Standardized Payment Amount | 3863.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5559 |
| Number Of Medicare Beneficiaries With Medical Services | 918 |
| Total Medical Submitted Charge Amount | 496237 |
| Total Medical Medicare Allowed Amount | 394106.88 |
| Total Medical Medicare Payment Amount | 278384.11 |
| Total Medical Medicare Standardized Payment Amount | 284457.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 420 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 406 |
| Number Of Non Hispanic White Beneficiaries | 869 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 793 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.292 |