National Provider Identifier [NPI]: |
1912976523 |
Last Name Of The Provider |
WETZEL |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2330 SHAWNEE MISSION PKWY |
Street Address 2 Of The Provider |
SUITE2201 |
City Of The Provider |
WESTWOOD |
Zip Code Of The Provider |
662052005 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1134 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
122595.8 |
Total Medicare Allowed Amount |
82034.19 |
Total Medicare Payment Amount |
63275.22 |
Total Medicare Standardized Payment Amount |
68062.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
199 |
Number Of Medicare Beneficiaries With Drug Services |
106 |
Total Drug Submitted ChargeAmount |
6923.8 |
Total Drug Medicare AllowedAmount |
5151.54 |
Total Drug Medicare PaymentAmount |
4831.94 |
Total Drug Medicare Standardized Payment Amount |
4831.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
935 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
115672 |
Total Medical Medicare Allowed Amount |
76882.65 |
Total Medical Medicare Payment Amount |
58443.28 |
Total Medical Medicare Standardized Payment Amount |
63230.21 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
223 |
Number Of Black or African American Beneficiaries |
15 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0693 |