National Provider Identifier [NPI]: |
1639146665 |
Last Name Of The Provider |
WOLF |
First Name Of The Provider |
ALICIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 ARCH ST |
Street Address 2 Of The Provider |
STE 2H |
City Of The Provider |
AKRON |
Zip Code Of The Provider |
443041423 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
1448 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
190380 |
Total Medicare Allowed Amount |
110919.16 |
Total Medicare Payment Amount |
84588.45 |
Total Medicare Standardized Payment Amount |
102392.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
300 |
Total Drug Medicare AllowedAmount |
102.96 |
Total Drug Medicare PaymentAmount |
100.92 |
Total Drug Medicare Standardized Payment Amount |
100.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
1436 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
190080 |
Total Medical Medicare Allowed Amount |
110816.2 |
Total Medical Medicare Payment Amount |
84487.53 |
Total Medical Medicare Standardized Payment Amount |
102291.93 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
207 |
Number Of Black or African American Beneficiaries |
|
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 |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
68 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.2495 |