National Provider Identifier [NPI]: |
1528079951 |
Last Name Of The Provider |
WYNEGAR |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
844 KEMPSVILLE RD |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235023927 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
192 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
22711 |
Total Medicare Allowed Amount |
9544.21 |
Total Medicare Payment Amount |
6960.81 |
Total Medicare Standardized Payment Amount |
8488.85 |
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 |
6 |
Number Of Medical Services |
192 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
22711 |
Total Medical Medicare Allowed Amount |
9544.21 |
Total Medical Medicare Payment Amount |
6960.81 |
Total Medical Medicare Standardized Payment Amount |
8488.85 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
43 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9104 |