National Provider Identifier [NPI]: |
1598790099 |
Last Name Of The Provider |
WITHERELL |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3411 SILVERSIDE ROAD |
Street Address 2 Of The Provider |
SUITE 103 RODNEY BUILDING |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
19810 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
4462 |
Number Of Medicare Beneficiaries |
551 |
Total Submitted Charge Amount |
3776677.98 |
Total Medicare Allowed Amount |
518551.6 |
Total Medicare Payment Amount |
397124.11 |
Total Medicare Standardized Payment Amount |
351234.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
1461 |
Number Of Medicare Beneficiaries With Drug Services |
435 |
Total Drug Submitted ChargeAmount |
23376 |
Total Drug Medicare AllowedAmount |
4385.55 |
Total Drug Medicare PaymentAmount |
3402.6 |
Total Drug Medicare Standardized Payment Amount |
3402.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
3001 |
Number Of Medicare Beneficiaries With Medical Services |
551 |
Total Medical Submitted Charge Amount |
3753301.98 |
Total Medical Medicare Allowed Amount |
514166.05 |
Total Medical Medicare Payment Amount |
393721.51 |
Total Medical Medicare Standardized Payment Amount |
347832.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
462 |
Number Of Black or African American Beneficiaries |
76 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
489 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0899 |