National Provider Identifier [NPI]: |
1033324900 |
Last Name Of The Provider |
WOLFERT |
First Name Of The Provider |
JARED |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28050 GRAND RIVER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON HILLS |
Zip Code Of The Provider |
483365919 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1790 |
Number Of Medicare Beneficiaries |
534 |
Total Submitted Charge Amount |
483738 |
Total Medicare Allowed Amount |
167782.93 |
Total Medicare Payment Amount |
128683.22 |
Total Medicare Standardized Payment Amount |
130713.95 |
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 |
39 |
Number Of Medical Services |
1790 |
Number Of Medicare Beneficiaries With Medical Services |
534 |
Total Medical Submitted Charge Amount |
483738 |
Total Medical Medicare Allowed Amount |
167782.93 |
Total Medical Medicare Payment Amount |
128683.22 |
Total Medical Medicare Standardized Payment Amount |
130713.95 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
360 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0553 |