National Provider Identifier [NPI]: |
1518942614 |
Last Name Of The Provider |
WOLF |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28625 NORTHWESTERN HWY |
Street Address 2 Of The Provider |
SUITE 213 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480341828 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
615 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
48205 |
Total Medicare Allowed Amount |
34432.87 |
Total Medicare Payment Amount |
24086.91 |
Total Medicare Standardized Payment Amount |
23765.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
86 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
2904 |
Total Drug Medicare AllowedAmount |
2251.52 |
Total Drug Medicare PaymentAmount |
2173.16 |
Total Drug Medicare Standardized Payment Amount |
2173.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
45301 |
Total Medical Medicare Allowed Amount |
32181.35 |
Total Medical Medicare Payment Amount |
21913.75 |
Total Medical Medicare Standardized Payment Amount |
21592.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
22 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
78 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9657 |