National Provider Identifier [NPI]: |
1760623110 |
Last Name Of The Provider |
WOIKE |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10400 75TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENOSHA |
Zip Code Of The Provider |
531427884 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
729 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
125102.43 |
Total Medicare Allowed Amount |
41408.84 |
Total Medicare Payment Amount |
29900.61 |
Total Medicare Standardized Payment Amount |
31652.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
2253.43 |
Total Drug Medicare AllowedAmount |
1225.65 |
Total Drug Medicare PaymentAmount |
1154.95 |
Total Drug Medicare Standardized Payment Amount |
1154.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
675 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
122849 |
Total Medical Medicare Allowed Amount |
40183.19 |
Total Medical Medicare Payment Amount |
28745.66 |
Total Medical Medicare Standardized Payment Amount |
30497.32 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
101 |
Number Of Black or African American Beneficiaries |
23 |
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 |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1197 |