National Provider Identifier [NPI]: |
1992905939 |
Last Name Of The Provider |
WOO |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12800 MISSISSIPPI PKWY |
Street Address 2 Of The Provider |
SUITE C101 |
City Of The Provider |
CROWN POINT |
Zip Code Of The Provider |
463076900 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
566 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
326519.5 |
Total Medicare Allowed Amount |
102300.74 |
Total Medicare Payment Amount |
79453.89 |
Total Medicare Standardized Payment Amount |
82220.37 |
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 |
82 |
Number Of Medical Services |
566 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
326519.5 |
Total Medical Medicare Allowed Amount |
102300.74 |
Total Medical Medicare Payment Amount |
79453.89 |
Total Medical Medicare Standardized Payment Amount |
82220.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
212 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7463 |