National Provider Identifier [NPI]: |
1174610745 |
Last Name Of The Provider |
WILMANSKI |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2845 CAPITAL AVE SW |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
BATTLE CREEK |
Zip Code Of The Provider |
490154185 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
94 |
Number Of Services |
6617 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
390196 |
Total Medicare Allowed Amount |
224600.72 |
Total Medicare Payment Amount |
161623.9 |
Total Medicare Standardized Payment Amount |
170585.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
319 |
Number Of Medicare Beneficiaries With Drug Services |
221 |
Total Drug Submitted ChargeAmount |
7229 |
Total Drug Medicare AllowedAmount |
5334.04 |
Total Drug Medicare PaymentAmount |
5063.04 |
Total Drug Medicare Standardized Payment Amount |
5063.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
6298 |
Number Of Medicare Beneficiaries With Medical Services |
576 |
Total Medical Submitted Charge Amount |
382967 |
Total Medical Medicare Allowed Amount |
219266.68 |
Total Medical Medicare Payment Amount |
156560.86 |
Total Medical Medicare Standardized Payment Amount |
165522.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
177 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
274 |
Number Of Non Hispanic White Beneficiaries |
535 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
540 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1356 |