National Provider Identifier [NPI]: |
1568414688 |
Last Name Of The Provider |
WICKLIFFE |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
275 COLLIER RD NW |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303091709 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Electrophysiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
89 |
Number Of Services |
4819 |
Number Of Medicare Beneficiaries |
2456 |
Total Submitted Charge Amount |
1089833.2 |
Total Medicare Allowed Amount |
322533.86 |
Total Medicare Payment Amount |
242043.71 |
Total Medicare Standardized Payment Amount |
245400.9 |
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 |
89 |
Number Of Medical Services |
4819 |
Number Of Medicare Beneficiaries With Medical Services |
2456 |
Total Medical Submitted Charge Amount |
1089833.2 |
Total Medical Medicare Allowed Amount |
322533.86 |
Total Medical Medicare Payment Amount |
242043.71 |
Total Medical Medicare Standardized Payment Amount |
245400.9 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
353 |
Number Of Beneficiaries Age 65 to 74 |
932 |
Number Of Beneficiaries Age 75 to 84 |
750 |
Number Of Beneficiaries Age Greater 84 |
421 |
Number Of Female Beneficiaries |
1105 |
Number Of Male Beneficiaries |
1351 |
Number Of Non Hispanic White Beneficiaries |
1822 |
Number Of Black or African American Beneficiaries |
554 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
2098 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
358 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0912 |