| National Provider Identifier [NPI]: | 1184714115 |
| Last Name Of The Provider | PERLICK |
| First Name Of The Provider | WYNN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 WILLARD ST |
| Street Address 2 Of The Provider | SUITE 2F |
| City Of The Provider | QUINCY |
| Zip Code Of The Provider | 021691200 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3111 |
| Number Of Medicare Beneficiaries | 669 |
| Total Submitted Charge Amount | 477079 |
| Total Medicare Allowed Amount | 168526.92 |
| Total Medicare Payment Amount | 122399.48 |
| Total Medicare Standardized Payment Amount | 115750.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 152 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1000 |
| Total Drug Medicare AllowedAmount | 316.72 |
| Total Drug Medicare PaymentAmount | 242.69 |
| Total Drug Medicare Standardized Payment Amount | 242.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2959 |
| Number Of Medicare Beneficiaries With Medical Services | 669 |
| Total Medical Submitted Charge Amount | 476079 |
| Total Medical Medicare Allowed Amount | 168210.2 |
| Total Medical Medicare Payment Amount | 122156.79 |
| Total Medical Medicare Standardized Payment Amount | 115507.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 263 |
| Number Of Beneficiaries Age 75 to 84 | 208 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 342 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| Number Of Black or African American Beneficiaries | |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4245 |