National Provider Identifier [NPI]: |
1114921095 |
Last Name Of The Provider |
WOODARD |
First Name Of The Provider |
KRISTIN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7640 SYLVANIA AVE |
Street Address 2 Of The Provider |
SUITE K |
City Of The Provider |
SYLVANIA |
Zip Code Of The Provider |
435609729 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
1448 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
100648.5 |
Total Medicare Allowed Amount |
68133.69 |
Total Medicare Payment Amount |
49555.37 |
Total Medicare Standardized Payment Amount |
51251.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
122 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
6945.5 |
Total Drug Medicare AllowedAmount |
5106.98 |
Total Drug Medicare PaymentAmount |
4960.34 |
Total Drug Medicare Standardized Payment Amount |
4960.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
1326 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
93703 |
Total Medical Medicare Allowed Amount |
63026.71 |
Total Medical Medicare Payment Amount |
44595.03 |
Total Medical Medicare Standardized Payment Amount |
46290.79 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
18 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9643 |