National Provider Identifier [NPI]: |
1306845425 |
Last Name Of The Provider |
WILKIN |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
609 FORD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAUMEE |
Zip Code Of The Provider |
435371947 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
3316 |
Number Of Medicare Beneficiaries |
629 |
Total Submitted Charge Amount |
310496 |
Total Medicare Allowed Amount |
178402.66 |
Total Medicare Payment Amount |
126905.03 |
Total Medicare Standardized Payment Amount |
134787.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
268 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1120 |
Total Drug Medicare AllowedAmount |
156.28 |
Total Drug Medicare PaymentAmount |
113.52 |
Total Drug Medicare Standardized Payment Amount |
113.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
3048 |
Number Of Medicare Beneficiaries With Medical Services |
629 |
Total Medical Submitted Charge Amount |
309376 |
Total Medical Medicare Allowed Amount |
178246.38 |
Total Medical Medicare Payment Amount |
126791.51 |
Total Medical Medicare Standardized Payment Amount |
134673.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
197 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
357 |
Number Of Male Beneficiaries |
272 |
Number Of Non Hispanic White Beneficiaries |
579 |
Number Of Black or African American Beneficiaries |
32 |
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 |
539 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6069 |