National Provider Identifier [NPI]: |
1053612747 |
Last Name Of The Provider |
WHEELER |
First Name Of The Provider |
CLINTON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 E BUSINESS WAY |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452412374 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
182 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
115708 |
Total Medicare Allowed Amount |
18982.2 |
Total Medicare Payment Amount |
14716.91 |
Total Medicare Standardized Payment Amount |
17479.54 |
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 |
18 |
Number Of Medical Services |
182 |
Number Of Medicare Beneficiaries With Medical Services |
164 |
Total Medical Submitted Charge Amount |
115708 |
Total Medical Medicare Allowed Amount |
18982.2 |
Total Medical Medicare Payment Amount |
14716.91 |
Total Medical Medicare Standardized Payment Amount |
17479.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
138 |
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 |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8961 |