National Provider Identifier [NPI]: |
1851338032 |
Last Name Of The Provider |
NWILOH |
First Name Of The Provider |
VICTOR |
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 |
1200 7TH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337051300 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1992 |
Number Of Medicare Beneficiaries |
572 |
Total Submitted Charge Amount |
488166 |
Total Medicare Allowed Amount |
207466.88 |
Total Medicare Payment Amount |
162454.44 |
Total Medicare Standardized Payment Amount |
164842.19 |
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 |
26 |
Number Of Medical Services |
1992 |
Number Of Medicare Beneficiaries With Medical Services |
572 |
Total Medical Submitted Charge Amount |
488166 |
Total Medical Medicare Allowed Amount |
207466.88 |
Total Medical Medicare Payment Amount |
162454.44 |
Total Medical Medicare Standardized Payment Amount |
164842.19 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
348 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
410 |
Number Of Black or African American Beneficiaries |
111 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
364 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
19 |
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 |
38 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4448 |