National Provider Identifier [NPI]: |
1699792242 |
Last Name Of The Provider |
WINGFIELD |
First Name Of The Provider |
GUITO |
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 |
1707 COOKS HILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CENTRALIA |
Zip Code Of The Provider |
985319071 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
2339 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
246748 |
Total Medicare Allowed Amount |
131759.96 |
Total Medicare Payment Amount |
91837.46 |
Total Medicare Standardized Payment Amount |
93292.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
187 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
2373 |
Total Drug Medicare AllowedAmount |
754.25 |
Total Drug Medicare PaymentAmount |
582.18 |
Total Drug Medicare Standardized Payment Amount |
582.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
2152 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
244375 |
Total Medical Medicare Allowed Amount |
131005.71 |
Total Medical Medicare Payment Amount |
91255.28 |
Total Medical Medicare Standardized Payment Amount |
92709.99 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
97 |
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
465 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3994 |