National Provider Identifier [NPI]: |
1720037161 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 PEACHTREE ST. |
Street Address 2 Of The Provider |
DEPARTMENT OF EMERGENCY MEDICINE, GROUND FLOOR |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
30308 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
332 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
116422 |
Total Medicare Allowed Amount |
36243.33 |
Total Medicare Payment Amount |
27509.38 |
Total Medicare Standardized Payment Amount |
27424.81 |
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 |
19 |
Number Of Medical Services |
332 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
116422 |
Total Medical Medicare Allowed Amount |
36243.33 |
Total Medical Medicare Payment Amount |
27509.38 |
Total Medical Medicare Standardized Payment Amount |
27424.81 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
155 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.6802 |