National Provider Identifier [NPI]: |
1508023029 |
Last Name Of The Provider |
WILSON |
First Name Of The Provider |
ZACHARY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
927 |
Number Of Medicare Beneficiaries |
682 |
Total Submitted Charge Amount |
423859.9 |
Total Medicare Allowed Amount |
105513.85 |
Total Medicare Payment Amount |
81122.06 |
Total Medicare Standardized Payment Amount |
81484.16 |
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 |
33 |
Number Of Medical Services |
927 |
Number Of Medicare Beneficiaries With Medical Services |
682 |
Total Medical Submitted Charge Amount |
423859.9 |
Total Medical Medicare Allowed Amount |
105513.85 |
Total Medical Medicare Payment Amount |
81122.06 |
Total Medical Medicare Standardized Payment Amount |
81484.16 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
228 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
386 |
Number Of Male Beneficiaries |
296 |
Number Of Non Hispanic White Beneficiaries |
486 |
Number Of Black or African American Beneficiaries |
165 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
392 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
290 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9879 |