National Provider Identifier [NPI]: |
1134171895 |
Last Name Of The Provider |
WILLINGHAM |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 RIVER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENWOOD |
Zip Code Of The Provider |
389304212 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1679 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
231752 |
Total Medicare Allowed Amount |
140952.76 |
Total Medicare Payment Amount |
107403.63 |
Total Medicare Standardized Payment Amount |
115181.8 |
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 |
23 |
Number Of Medical Services |
1679 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
231752 |
Total Medical Medicare Allowed Amount |
140952.76 |
Total Medical Medicare Payment Amount |
107403.63 |
Total Medical Medicare Standardized Payment Amount |
115181.8 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
194 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.9311 |