National Provider Identifier [NPI]: |
1093773061 |
Last Name Of The Provider |
WILKEY |
First Name Of The Provider |
VICKI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7250 CLEARVISTA DR |
Street Address 2 Of The Provider |
SUITE 260 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462564649 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
18326 |
Total Medicare Allowed Amount |
11495.18 |
Total Medicare Payment Amount |
8484.83 |
Total Medicare Standardized Payment Amount |
10285.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
3539 |
Total Drug Medicare AllowedAmount |
2113.4 |
Total Drug Medicare PaymentAmount |
2052.99 |
Total Drug Medicare Standardized Payment Amount |
2052.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
140 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
14787 |
Total Medical Medicare Allowed Amount |
9381.78 |
Total Medical Medicare Payment Amount |
6431.84 |
Total Medical Medicare Standardized Payment Amount |
8232.42 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
49 |
Number Of Black or African American Beneficiaries |
|
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 |
32 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2513 |