National Provider Identifier [NPI]: |
1154527745 |
Last Name Of The Provider |
WILMOT |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 LOCUST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
152195114 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
1559 |
Number Of Medicare Beneficiaries |
877 |
Total Submitted Charge Amount |
109042 |
Total Medicare Allowed Amount |
28751.67 |
Total Medicare Payment Amount |
21900.37 |
Total Medicare Standardized Payment Amount |
22738.53 |
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 |
84 |
Number Of Medical Services |
1559 |
Number Of Medicare Beneficiaries With Medical Services |
877 |
Total Medical Submitted Charge Amount |
109042 |
Total Medical Medicare Allowed Amount |
28751.67 |
Total Medical Medicare Payment Amount |
21900.37 |
Total Medical Medicare Standardized Payment Amount |
22738.53 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
249 |
Number Of Beneficiaries Age 65 to 74 |
310 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
499 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
716 |
Number Of Black or African American Beneficiaries |
131 |
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 |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
646 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
231 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6674 |