National Provider Identifier [NPI]: |
1548201718 |
Last Name Of The Provider |
WILKIE |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1147 |
Number Of Medicare Beneficiaries |
759 |
Total Submitted Charge Amount |
592494 |
Total Medicare Allowed Amount |
134757.62 |
Total Medicare Payment Amount |
104293.78 |
Total Medicare Standardized Payment Amount |
100642.3 |
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 |
33 |
Number Of Medical Services |
1147 |
Number Of Medicare Beneficiaries With Medical Services |
759 |
Total Medical Submitted Charge Amount |
592494 |
Total Medical Medicare Allowed Amount |
134757.62 |
Total Medical Medicare Payment Amount |
104293.78 |
Total Medical Medicare Standardized Payment Amount |
100642.3 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
271 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
460 |
Number Of Male Beneficiaries |
299 |
Number Of Non Hispanic White Beneficiaries |
457 |
Number Of Black or African American Beneficiaries |
264 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
461 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
298 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2845 |