National Provider Identifier [NPI]: |
1003014762 |
Last Name Of The Provider |
WHARTON |
First Name Of The Provider |
JOSHUA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2307 HOMER CLAYTON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
GUNTERSVILLE |
Zip Code Of The Provider |
359762205 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
16660 |
Number Of Medicare Beneficiaries |
2133 |
Total Submitted Charge Amount |
1756448 |
Total Medicare Allowed Amount |
1270036.99 |
Total Medicare Payment Amount |
947880.75 |
Total Medicare Standardized Payment Amount |
1026617.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
296 |
Number Of Medicare Beneficiaries With Drug Services |
166 |
Total Drug Submitted ChargeAmount |
75656 |
Total Drug Medicare AllowedAmount |
63948.67 |
Total Drug Medicare PaymentAmount |
49420.87 |
Total Drug Medicare Standardized Payment Amount |
49420.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
91 |
Number Of Medical Services |
16364 |
Number Of Medicare Beneficiaries With Medical Services |
2133 |
Total Medical Submitted Charge Amount |
1680792 |
Total Medical Medicare Allowed Amount |
1206088.32 |
Total Medical Medicare Payment Amount |
898459.88 |
Total Medical Medicare Standardized Payment Amount |
977196.16 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
181 |
Number Of Beneficiaries Age 65 to 74 |
993 |
Number Of Beneficiaries Age 75 to 84 |
740 |
Number Of Beneficiaries Age Greater 84 |
219 |
Number Of Female Beneficiaries |
1133 |
Number Of Male Beneficiaries |
1000 |
Number Of Non Hispanic White Beneficiaries |
2106 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1849 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
284 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9882 |