National Provider Identifier [NPI]: |
1952364606 |
Last Name Of The Provider |
WOLKE |
First Name Of The Provider |
CARRIE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8100 W 78TH ST STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINA |
Zip Code Of The Provider |
554392529 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
453 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
77313 |
Total Medicare Allowed Amount |
35942.05 |
Total Medicare Payment Amount |
27131.61 |
Total Medicare Standardized Payment Amount |
27818.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
2407 |
Total Drug Medicare AllowedAmount |
1463.64 |
Total Drug Medicare PaymentAmount |
1432.36 |
Total Drug Medicare Standardized Payment Amount |
1432.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
391 |
Number Of Medicare Beneficiaries With Medical Services |
172 |
Total Medical Submitted Charge Amount |
74906 |
Total Medical Medicare Allowed Amount |
34478.41 |
Total Medical Medicare Payment Amount |
25699.25 |
Total Medical Medicare Standardized Payment Amount |
26385.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
11 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8526 |