| National Provider Identifier [NPI]: | 1447248265 |
| Last Name Of The Provider | WOJCIECHOWSKI |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 970 W WOOSTER |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | BOWLING GREEN |
| Zip Code Of The Provider | 43402 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 4165 |
| Number Of Medicare Beneficiaries | 795 |
| Total Submitted Charge Amount | 272028 |
| Total Medicare Allowed Amount | 201008.85 |
| Total Medicare Payment Amount | 138914.05 |
| Total Medicare Standardized Payment Amount | 143518.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1377 |
| Total Drug Medicare AllowedAmount | 1184.41 |
| Total Drug Medicare PaymentAmount | 1159.5 |
| Total Drug Medicare Standardized Payment Amount | 1159.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 4141 |
| Number Of Medicare Beneficiaries With Medical Services | 795 |
| Total Medical Submitted Charge Amount | 270651 |
| Total Medical Medicare Allowed Amount | 199824.44 |
| Total Medical Medicare Payment Amount | 137754.55 |
| Total Medical Medicare Standardized Payment Amount | 142358.81 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 525 |
| Number Of Male Beneficiaries | 270 |
| Number Of Non Hispanic White Beneficiaries | 754 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 406 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0096 |