National Provider Identifier [NPI]: |
1053394171 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 E DIXIE AVE |
Street Address 2 Of The Provider |
MEDICAL PLAZA #401 |
City Of The Provider |
LEESBURG |
Zip Code Of The Provider |
347485953 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
5150 |
Number Of Medicare Beneficiaries |
1521 |
Total Submitted Charge Amount |
309610.16 |
Total Medicare Allowed Amount |
302211.16 |
Total Medicare Payment Amount |
224713.19 |
Total Medicare Standardized Payment Amount |
226250.37 |
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 |
37 |
Number Of Medical Services |
5150 |
Number Of Medicare Beneficiaries With Medical Services |
1521 |
Total Medical Submitted Charge Amount |
309610.16 |
Total Medical Medicare Allowed Amount |
302211.16 |
Total Medical Medicare Payment Amount |
224713.19 |
Total Medical Medicare Standardized Payment Amount |
226250.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
943 |
Number Of Beneficiaries Age 75 to 84 |
474 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
1521 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
1455 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1500 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8042 |