| National Provider Identifier [NPI]: | 1386753754 |
| Last Name Of The Provider | LONGAKER |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 777 HEMLOCK ST |
| Street Address 2 Of The Provider | HB 64 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312012102 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1130 |
| Number Of Medicare Beneficiaries | 927 |
| Total Submitted Charge Amount | 141680 |
| Total Medicare Allowed Amount | 57652.96 |
| Total Medicare Payment Amount | 38721.31 |
| Total Medicare Standardized Payment Amount | 41542.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1130 |
| Number Of Medicare Beneficiaries With Medical Services | 927 |
| Total Medical Submitted Charge Amount | 141680 |
| Total Medical Medicare Allowed Amount | 57652.96 |
| Total Medical Medicare Payment Amount | 38721.31 |
| Total Medical Medicare Standardized Payment Amount | 41542.93 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 310 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 575 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 521 |
| Number Of Black or African American Beneficiaries | 390 |
| 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 | 636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 291 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2611 |