National Provider Identifier [NPI]: |
1720060080 |
Last Name Of The Provider |
WOLFE |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11300 E 13 MILE RD |
Street Address 2 Of The Provider |
STE 4A |
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480932500 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
311 |
Number Of Medicare Beneficiaries |
172 |
Total Submitted Charge Amount |
40140 |
Total Medicare Allowed Amount |
24905.44 |
Total Medicare Payment Amount |
19222.68 |
Total Medicare Standardized Payment Amount |
18958.41 |
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 |
17 |
Number Of Medical Services |
311 |
Number Of Medicare Beneficiaries With Medical Services |
172 |
Total Medical Submitted Charge Amount |
40140 |
Total Medical Medicare Allowed Amount |
24905.44 |
Total Medical Medicare Payment Amount |
19222.68 |
Total Medical Medicare Standardized Payment Amount |
18958.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7534 |