| National Provider Identifier [NPI]: | 1700860913 |
| Last Name Of The Provider | WADE |
| First Name Of The Provider | JIM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 58 BIG A ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOCCOA |
| Zip Code Of The Provider | 305776017 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 13681 |
| Number Of Medicare Beneficiaries | 1258 |
| Total Submitted Charge Amount | 1105741 |
| Total Medicare Allowed Amount | 529117.52 |
| Total Medicare Payment Amount | 402981.33 |
| Total Medicare Standardized Payment Amount | 420945.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 1902 |
| Number Of Medicare Beneficiaries With Drug Services | 335 |
| Total Drug Submitted ChargeAmount | 48461 |
| Total Drug Medicare AllowedAmount | 23985.5 |
| Total Drug Medicare PaymentAmount | 20125.37 |
| Total Drug Medicare Standardized Payment Amount | 20125.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 11779 |
| Number Of Medicare Beneficiaries With Medical Services | 1258 |
| Total Medical Submitted Charge Amount | 1057280 |
| Total Medical Medicare Allowed Amount | 505132.02 |
| Total Medical Medicare Payment Amount | 382855.96 |
| Total Medical Medicare Standardized Payment Amount | 400820.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 473 |
| Number Of Beneficiaries Age 75 to 84 | 423 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 775 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 1179 |
| Number Of Black or African American Beneficiaries | 58 |
| 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 | 952 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 306 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3059 |