National Provider Identifier [NPI]: |
1659322899 |
Last Name Of The Provider |
WILEY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 RAINBOW BLVD |
Street Address 2 Of The Provider |
SUITE G600 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
661608500 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
2244 |
Number Of Medicare Beneficiaries |
974 |
Total Submitted Charge Amount |
399348 |
Total Medicare Allowed Amount |
217433.6 |
Total Medicare Payment Amount |
164799.73 |
Total Medicare Standardized Payment Amount |
174452.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
3328 |
Total Drug Medicare AllowedAmount |
2544.12 |
Total Drug Medicare PaymentAmount |
1994.6 |
Total Drug Medicare Standardized Payment Amount |
1994.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
2196 |
Number Of Medicare Beneficiaries With Medical Services |
974 |
Total Medical Submitted Charge Amount |
396020 |
Total Medical Medicare Allowed Amount |
214889.48 |
Total Medical Medicare Payment Amount |
162805.13 |
Total Medical Medicare Standardized Payment Amount |
172458.02 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
384 |
Number Of Beneficiaries Age 75 to 84 |
295 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
444 |
Number Of Male Beneficiaries |
530 |
Number Of Non Hispanic White Beneficiaries |
844 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
839 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8893 |