National Provider Identifier [NPI]: |
1821208794 |
Last Name Of The Provider |
WILEY |
First Name Of The Provider |
HAZEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4900 W OAKLAND PARK BLVD |
Street Address 2 Of The Provider |
SUITE 309 |
City Of The Provider |
LAUDERDALE LAKES |
Zip Code Of The Provider |
333137500 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1167 |
Number Of Medicare Beneficiaries |
483 |
Total Submitted Charge Amount |
292146.71 |
Total Medicare Allowed Amount |
107487.42 |
Total Medicare Payment Amount |
82571.34 |
Total Medicare Standardized Payment Amount |
80033.53 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
331 |
Number Of Black or African American Beneficiaries |
96 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
221 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
30 |
Average HCC Risk Score Of Beneficiaries |
2.0928 |