National Provider Identifier [NPI]: |
1578591483 |
Last Name Of The Provider |
WILKINS |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
125 S KALAMAZOO MALL |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490074832 |
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 |
26 |
Number Of Services |
1194 |
Number Of Medicare Beneficiaries |
790 |
Total Submitted Charge Amount |
433539 |
Total Medicare Allowed Amount |
126145.83 |
Total Medicare Payment Amount |
96712.81 |
Total Medicare Standardized Payment Amount |
98109.2 |
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 |
26 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
790 |
Total Medical Submitted Charge Amount |
433539 |
Total Medical Medicare Allowed Amount |
126145.83 |
Total Medical Medicare Payment Amount |
96712.81 |
Total Medical Medicare Standardized Payment Amount |
98109.2 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
266 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
445 |
Number Of Male Beneficiaries |
345 |
Number Of Non Hispanic White Beneficiaries |
730 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
313 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3355 |