National Provider Identifier [NPI]: |
1245240324 |
Last Name Of The Provider |
WILMARTH |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1830 SIERRA GARDENS DR |
Street Address 2 Of The Provider |
#100 |
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
95661 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
2647 |
Number Of Medicare Beneficiaries |
1192 |
Total Submitted Charge Amount |
673592 |
Total Medicare Allowed Amount |
436699.91 |
Total Medicare Payment Amount |
317237.44 |
Total Medicare Standardized Payment Amount |
305198.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
2647 |
Number Of Medicare Beneficiaries With Medical Services |
1192 |
Total Medical Submitted Charge Amount |
673592 |
Total Medical Medicare Allowed Amount |
436699.91 |
Total Medical Medicare Payment Amount |
317237.44 |
Total Medical Medicare Standardized Payment Amount |
305198.72 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
420 |
Number Of Beneficiaries Age 75 to 84 |
546 |
Number Of Beneficiaries Age Greater 84 |
195 |
Number Of Female Beneficiaries |
719 |
Number Of Male Beneficiaries |
473 |
Number Of Non Hispanic White Beneficiaries |
1075 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
41 |
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0397 |