| National Provider Identifier [NPI]: | 1639164536 |
| Last Name Of The Provider | WOMACK |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 732 ELIZAVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLEMINGSBURG |
| Zip Code Of The Provider | 410411139 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 243 |
| Number Of Services | 13921 |
| Number Of Medicare Beneficiaries | 613 |
| Total Submitted Charge Amount | 1616164.2 |
| Total Medicare Allowed Amount | 670377.36 |
| Total Medicare Payment Amount | 510161.1 |
| Total Medicare Standardized Payment Amount | 558816.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 2146 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 42147.2 |
| Total Drug Medicare AllowedAmount | 19038.22 |
| Total Drug Medicare PaymentAmount | 14482 |
| Total Drug Medicare Standardized Payment Amount | 14482 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 228 |
| Number Of Medical Services | 11775 |
| Number Of Medicare Beneficiaries With Medical Services | 613 |
| Total Medical Submitted Charge Amount | 1574017 |
| Total Medical Medicare Allowed Amount | 651339.14 |
| Total Medical Medicare Payment Amount | 495679.1 |
| Total Medical Medicare Standardized Payment Amount | 544334.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 589 |
| 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 | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 258 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4369 |