National Provider Identifier [NPI]: |
1417920240 |
Last Name Of The Provider |
WHEATLEY |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 20TH ST |
Street Address 2 Of The Provider |
SUITE 505 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379161809 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2023 |
Number Of Medicare Beneficiaries |
764 |
Total Submitted Charge Amount |
284923 |
Total Medicare Allowed Amount |
145794.7 |
Total Medicare Payment Amount |
105449.29 |
Total Medicare Standardized Payment Amount |
113616.96 |
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 |
25 |
Number Of Medical Services |
2023 |
Number Of Medicare Beneficiaries With Medical Services |
764 |
Total Medical Submitted Charge Amount |
284923 |
Total Medical Medicare Allowed Amount |
145794.7 |
Total Medical Medicare Payment Amount |
105449.29 |
Total Medical Medicare Standardized Payment Amount |
113616.96 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
302 |
Number Of Beneficiaries Age 65 to 74 |
237 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
424 |
Number Of Male Beneficiaries |
340 |
Number Of Non Hispanic White Beneficiaries |
693 |
Number Of Black or African American Beneficiaries |
50 |
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 |
517 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
247 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.6014 |