National Provider Identifier [NPI]: |
1841290582 |
Last Name Of The Provider |
WILLETT |
First Name Of The Provider |
DARRYL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1810 MACKENZIE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432202967 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
755 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
141980 |
Total Medicare Allowed Amount |
81560.58 |
Total Medicare Payment Amount |
60192.75 |
Total Medicare Standardized Payment Amount |
63187.56 |
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 |
64 |
Number Of Medical Services |
755 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
141980 |
Total Medical Medicare Allowed Amount |
81560.58 |
Total Medical Medicare Payment Amount |
60192.75 |
Total Medical Medicare Standardized Payment Amount |
63187.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
321 |
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 |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1444 |