National Provider Identifier [NPI]: |
1578735551 |
Last Name Of The Provider |
WILKERSON |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 S PACA ST |
Street Address 2 Of The Provider |
SUITE 200, 6TH FLOOR |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212011642 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
328 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
137145 |
Total Medicare Allowed Amount |
41630.66 |
Total Medicare Payment Amount |
31243.99 |
Total Medicare Standardized Payment Amount |
29898.55 |
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 |
22 |
Number Of Medical Services |
328 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
137145 |
Total Medical Medicare Allowed Amount |
41630.66 |
Total Medical Medicare Payment Amount |
31243.99 |
Total Medical Medicare Standardized Payment Amount |
29898.55 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
197 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4654 |