National Provider Identifier [NPI]: |
1588628572 |
Last Name Of The Provider |
WOLF |
First Name Of The Provider |
CARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5557 TADWORTH PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST BLOOMFIELD |
Zip Code Of The Provider |
483224016 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
2134 |
Number Of Medicare Beneficiaries |
390 |
Total Submitted Charge Amount |
141310 |
Total Medicare Allowed Amount |
117201.2 |
Total Medicare Payment Amount |
87594.41 |
Total Medicare Standardized Payment Amount |
85322.76 |
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 |
2134 |
Number Of Medicare Beneficiaries With Medical Services |
390 |
Total Medical Submitted Charge Amount |
141310 |
Total Medical Medicare Allowed Amount |
117201.2 |
Total Medical Medicare Payment Amount |
87594.41 |
Total Medical Medicare Standardized Payment Amount |
85322.76 |
Average Age Of Beneficiaries |
84 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
220 |
Number Of Female Beneficiaries |
237 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
335 |
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 |
340 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
45 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.2296 |