| National Provider Identifier [NPI]: | 1972558773 |
| Last Name Of The Provider | WEWERS |
| First Name Of The Provider | DONAVON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1118 ROSS CLARK CIR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013001 |
| 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 | 96 |
| Number Of Services | 11835 |
| Number Of Medicare Beneficiaries | 1760 |
| Total Submitted Charge Amount | 666783.75 |
| Total Medicare Allowed Amount | 457535.45 |
| Total Medicare Payment Amount | 342337.31 |
| Total Medicare Standardized Payment Amount | 371450.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 864 |
| Number Of Medicare Beneficiaries With Drug Services | 543 |
| Total Drug Submitted ChargeAmount | 22562 |
| Total Drug Medicare AllowedAmount | 14778.3 |
| Total Drug Medicare PaymentAmount | 13822.62 |
| Total Drug Medicare Standardized Payment Amount | 13822.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 10971 |
| Number Of Medicare Beneficiaries With Medical Services | 1760 |
| Total Medical Submitted Charge Amount | 644221.75 |
| Total Medical Medicare Allowed Amount | 442757.15 |
| Total Medical Medicare Payment Amount | 328514.69 |
| Total Medical Medicare Standardized Payment Amount | 357628.26 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 326 |
| Number Of Beneficiaries Age 65 to 74 | 743 |
| Number Of Beneficiaries Age 75 to 84 | 509 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 1007 |
| Number Of Male Beneficiaries | 753 |
| Number Of Non Hispanic White Beneficiaries | 1436 |
| Number Of Black or African American Beneficiaries | 298 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 459 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.459 |