| National Provider Identifier [NPI]: | 1003807355 |
| Last Name Of The Provider | FAMOYIN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 N STATE OF FRANKLIN RD |
| Street Address 2 Of The Provider | SUITE 401 |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376046008 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 65223.5 |
| Number Of Medicare Beneficiaries | 830 |
| Total Submitted Charge Amount | 4195037.79 |
| Total Medicare Allowed Amount | 1148360.04 |
| Total Medicare Payment Amount | 885698.95 |
| Total Medicare Standardized Payment Amount | 920033.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 57 |
| Number Of Drug Services | 42708.5 |
| Number Of Medicare Beneficiaries With Drug Services | 397 |
| Total Drug Submitted ChargeAmount | 1248717.39 |
| Total Drug Medicare AllowedAmount | 339996.51 |
| Total Drug Medicare PaymentAmount | 264511.41 |
| Total Drug Medicare Standardized Payment Amount | 264511.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 22515 |
| Number Of Medicare Beneficiaries With Medical Services | 830 |
| Total Medical Submitted Charge Amount | 2946320.4 |
| Total Medical Medicare Allowed Amount | 808363.53 |
| Total Medical Medicare Payment Amount | 621187.54 |
| Total Medical Medicare Standardized Payment Amount | 655522.48 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 259 |
| Number Of Beneficiaries Age 75 to 84 | 159 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 798 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 395 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6548 |