National Provider Identifier [NPI]: |
1205886728 |
Last Name Of The Provider |
WOJNO |
First Name Of The Provider |
TED |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1365B CLIFTON RD NE |
Street Address 2 Of The Provider |
BUILDING B RM 4500 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
30322 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
9259 |
Number Of Medicare Beneficiaries |
454 |
Total Submitted Charge Amount |
1056526 |
Total Medicare Allowed Amount |
257081.23 |
Total Medicare Payment Amount |
193651.88 |
Total Medicare Standardized Payment Amount |
173864.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
8391 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
140363 |
Total Drug Medicare AllowedAmount |
45561.48 |
Total Drug Medicare PaymentAmount |
32786.4 |
Total Drug Medicare Standardized Payment Amount |
32786.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
868 |
Number Of Medicare Beneficiaries With Medical Services |
453 |
Total Medical Submitted Charge Amount |
916163 |
Total Medical Medicare Allowed Amount |
211519.75 |
Total Medical Medicare Payment Amount |
160865.48 |
Total Medical Medicare Standardized Payment Amount |
141078.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
281 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
389 |
Number Of Black or African American Beneficiaries |
50 |
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 |
404 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.084 |