| National Provider Identifier [NPI]: | 1164413308 |
| Last Name Of The Provider | CHITTOM |
| First Name Of The Provider | PARK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 509 PARKMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SELMA |
| Zip Code Of The Provider | 367015734 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 10369 |
| Number Of Medicare Beneficiaries | 2510 |
| Total Submitted Charge Amount | 422760 |
| Total Medicare Allowed Amount | 345468.36 |
| Total Medicare Payment Amount | 249146.78 |
| Total Medicare Standardized Payment Amount | 270767.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 523 |
| Number Of Medicare Beneficiaries With Drug Services | 266 |
| Total Drug Submitted ChargeAmount | 10671 |
| Total Drug Medicare AllowedAmount | 6216.3 |
| Total Drug Medicare PaymentAmount | 5765.91 |
| Total Drug Medicare Standardized Payment Amount | 5765.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 9846 |
| Number Of Medicare Beneficiaries With Medical Services | 2510 |
| Total Medical Submitted Charge Amount | 412089 |
| Total Medical Medicare Allowed Amount | 339252.06 |
| Total Medical Medicare Payment Amount | 243380.87 |
| Total Medical Medicare Standardized Payment Amount | 265002.04 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 703 |
| Number Of Beneficiaries Age 65 to 74 | 797 |
| Number Of Beneficiaries Age 75 to 84 | 667 |
| Number Of Beneficiaries Age Greater 84 | 343 |
| Number Of Female Beneficiaries | 1436 |
| Number Of Male Beneficiaries | 1074 |
| Number Of Non Hispanic White Beneficiaries | 953 |
| Number Of Black or African American Beneficiaries | 1539 |
| 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 | 1264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1246 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7744 |