National Provider Identifier [NPI]: |
1841284858 |
Last Name Of The Provider |
WIN |
First Name Of The Provider |
MYO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 S BABCOCK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
329011459 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
4977 |
Number Of Medicare Beneficiaries |
402 |
Total Submitted Charge Amount |
328501.72 |
Total Medicare Allowed Amount |
216328.44 |
Total Medicare Payment Amount |
160847.51 |
Total Medicare Standardized Payment Amount |
163446.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
234 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
4414.54 |
Total Drug Medicare AllowedAmount |
1172.12 |
Total Drug Medicare PaymentAmount |
987.42 |
Total Drug Medicare Standardized Payment Amount |
987.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
82 |
Number Of Medical Services |
4743 |
Number Of Medicare Beneficiaries With Medical Services |
402 |
Total Medical Submitted Charge Amount |
324087.18 |
Total Medical Medicare Allowed Amount |
215156.32 |
Total Medical Medicare Payment Amount |
159860.09 |
Total Medical Medicare Standardized Payment Amount |
162459.44 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
314 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
353 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1035 |