| National Provider Identifier [NPI]: | 1669445532 |
| Last Name Of The Provider | ADCOCK |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 E 12TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH PITTSBURG |
| Zip Code Of The Provider | 373801633 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 3180 |
| Number Of Medicare Beneficiaries | 379 |
| Total Submitted Charge Amount | 279745 |
| Total Medicare Allowed Amount | 110144.57 |
| Total Medicare Payment Amount | 75839.83 |
| Total Medicare Standardized Payment Amount | 83340.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 996 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 15220 |
| Total Drug Medicare AllowedAmount | 4354.2 |
| Total Drug Medicare PaymentAmount | 3456.17 |
| Total Drug Medicare Standardized Payment Amount | 3456.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 2184 |
| Number Of Medicare Beneficiaries With Medical Services | 379 |
| Total Medical Submitted Charge Amount | 264525 |
| Total Medical Medicare Allowed Amount | 105790.37 |
| Total Medical Medicare Payment Amount | 72383.66 |
| Total Medical Medicare Standardized Payment Amount | 79883.88 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| 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 | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0958 |