National Provider Identifier [NPI]: |
1073573044 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 SOUTH COLUMBIA ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND FORKS |
Zip Code Of The Provider |
582066002 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
855 |
Number Of Medicare Beneficiaries |
510 |
Total Submitted Charge Amount |
482095 |
Total Medicare Allowed Amount |
137273.87 |
Total Medicare Payment Amount |
108045.38 |
Total Medicare Standardized Payment Amount |
113775.56 |
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 |
45 |
Number Of Medical Services |
855 |
Number Of Medicare Beneficiaries With Medical Services |
510 |
Total Medical Submitted Charge Amount |
482095 |
Total Medical Medicare Allowed Amount |
137273.87 |
Total Medical Medicare Payment Amount |
108045.38 |
Total Medical Medicare Standardized Payment Amount |
113775.56 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
467 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
29 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
380 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.6158 |