National Provider Identifier [NPI]: |
1407847668 |
Last Name Of The Provider |
WILKERSON |
First Name Of The Provider |
MICHAEL |
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 |
1900 MEDI PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMARILLO |
Zip Code Of The Provider |
791062104 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
5722 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
591767.25 |
Total Medicare Allowed Amount |
199978.74 |
Total Medicare Payment Amount |
149305.81 |
Total Medicare Standardized Payment Amount |
158637 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
2678 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
140070.25 |
Total Drug Medicare AllowedAmount |
39470.71 |
Total Drug Medicare PaymentAmount |
30882.84 |
Total Drug Medicare Standardized Payment Amount |
30882.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
3044 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
451697 |
Total Medical Medicare Allowed Amount |
160508.03 |
Total Medical Medicare Payment Amount |
118422.97 |
Total Medical Medicare Standardized Payment Amount |
127754.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
379 |
Number Of Non Hispanic White Beneficiaries |
470 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
484 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2298 |