National Provider Identifier [NPI]: |
1114003480 |
Last Name Of The Provider |
WYLIE |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11219 FINANCIAL CENTRE PKWY |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722113800 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Sleep Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
649 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
171576 |
Total Medicare Allowed Amount |
78164.66 |
Total Medicare Payment Amount |
56593.27 |
Total Medicare Standardized Payment Amount |
61862.53 |
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 |
13 |
Number Of Medical Services |
649 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
171576 |
Total Medical Medicare Allowed Amount |
78164.66 |
Total Medical Medicare Payment Amount |
56593.27 |
Total Medical Medicare Standardized Payment Amount |
61862.53 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
315 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
308 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0919 |