| National Provider Identifier [NPI]: | 1225128556 |
| Last Name Of The Provider | WOODHOUSE |
| First Name Of The Provider | JUSTIN |
| 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 | 1611 S GREEN RD |
| Street Address 2 Of The Provider | SUITE 146 |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441214128 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 5619 |
| Number Of Medicare Beneficiaries | 1050 |
| Total Submitted Charge Amount | 1795040.78 |
| Total Medicare Allowed Amount | 942485.04 |
| Total Medicare Payment Amount | 722200.11 |
| Total Medicare Standardized Payment Amount | 727781.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2616 |
| Total Drug Medicare AllowedAmount | 2484.93 |
| Total Drug Medicare PaymentAmount | 1813.44 |
| Total Drug Medicare Standardized Payment Amount | 1813.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 5573 |
| Number Of Medicare Beneficiaries With Medical Services | 1050 |
| Total Medical Submitted Charge Amount | 1792424.78 |
| Total Medical Medicare Allowed Amount | 940000.11 |
| Total Medical Medicare Payment Amount | 720386.67 |
| Total Medical Medicare Standardized Payment Amount | 725967.73 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 408 |
| Number Of Beneficiaries Age Greater 84 | 260 |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 614 |
| Number Of Non Hispanic White Beneficiaries | 1024 |
| Number Of Black or African American Beneficiaries | |
| 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 | 1005 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.076 |