| National Provider Identifier [NPI]: | 1942206776 |
| Last Name Of The Provider | WORLEY |
| First Name Of The Provider | CLYDE |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 HOSPITAL DR |
| Street Address 2 Of The Provider | STE 130 |
| City Of The Provider | JEFFERSON CITY |
| Zip Code Of The Provider | 377605279 |
| 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 | 157 |
| Number Of Services | 6806 |
| Number Of Medicare Beneficiaries | 802 |
| Total Submitted Charge Amount | 448151 |
| Total Medicare Allowed Amount | 226997.44 |
| Total Medicare Payment Amount | 175416.28 |
| Total Medicare Standardized Payment Amount | 187903.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 5542 |
| Total Drug Medicare AllowedAmount | 3501.91 |
| Total Drug Medicare PaymentAmount | 3394.04 |
| Total Drug Medicare Standardized Payment Amount | 3394.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 147 |
| Number Of Medical Services | 6642 |
| Number Of Medicare Beneficiaries With Medical Services | 802 |
| Total Medical Submitted Charge Amount | 442609 |
| Total Medical Medicare Allowed Amount | 223495.53 |
| Total Medical Medicare Payment Amount | 172022.24 |
| Total Medical Medicare Standardized Payment Amount | 184509.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 278 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 437 |
| Number Of Male Beneficiaries | 365 |
| Number Of Non Hispanic White Beneficiaries | 777 |
| 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 | 554 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 248 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3683 |