National Provider Identifier [NPI]: |
1518039296 |
Last Name Of The Provider |
GWINN |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
34597 N 60TH ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852665240 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
11474 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
341120 |
Total Medicare Allowed Amount |
196861.74 |
Total Medicare Payment Amount |
146575.39 |
Total Medicare Standardized Payment Amount |
149379.09 |
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 |
17 |
Number Of Medical Services |
11474 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
341120 |
Total Medical Medicare Allowed Amount |
196861.74 |
Total Medical Medicare Payment Amount |
146575.39 |
Total Medical Medicare Standardized Payment Amount |
149379.09 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
247 |
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 |
11 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1484 |