National Provider Identifier [NPI]: |
1891723540 |
Last Name Of The Provider |
WYNN |
First Name Of The Provider |
GAIL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
537 STANTON CHRISTIANA RD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197132146 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
753 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
346091 |
Total Medicare Allowed Amount |
152829.43 |
Total Medicare Payment Amount |
115449.88 |
Total Medicare Standardized Payment Amount |
116068.29 |
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 |
55 |
Number Of Medical Services |
753 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
346091 |
Total Medical Medicare Allowed Amount |
152829.43 |
Total Medical Medicare Payment Amount |
115449.88 |
Total Medical Medicare Standardized Payment Amount |
116068.29 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
181 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7606 |