National Provider Identifier [NPI]: |
1396981361 |
Last Name Of The Provider |
WUBIE |
First Name Of The Provider |
DAWIT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1840 AMHERST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINCHESTER |
Zip Code Of The Provider |
226012808 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1741 |
Number Of Medicare Beneficiaries |
812 |
Total Submitted Charge Amount |
393229.63 |
Total Medicare Allowed Amount |
198762.07 |
Total Medicare Payment Amount |
153521.12 |
Total Medicare Standardized Payment Amount |
154826.53 |
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 |
18 |
Number Of Medical Services |
1741 |
Number Of Medicare Beneficiaries With Medical Services |
812 |
Total Medical Submitted Charge Amount |
393229.63 |
Total Medical Medicare Allowed Amount |
198762.07 |
Total Medical Medicare Payment Amount |
153521.12 |
Total Medical Medicare Standardized Payment Amount |
154826.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
273 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
203 |
Number Of Female Beneficiaries |
480 |
Number Of Male Beneficiaries |
332 |
Number Of Non Hispanic White Beneficiaries |
746 |
Number Of Black or African American Beneficiaries |
55 |
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 |
599 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
213 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0871 |