National Provider Identifier [NPI]: |
1740470889 |
Last Name Of The Provider |
WSZOLEK |
First Name Of The Provider |
MATTHEW |
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 |
1515 HOLCOMBE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770304009 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1248 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
664151.75 |
Total Medicare Allowed Amount |
136700.85 |
Total Medicare Payment Amount |
102822.95 |
Total Medicare Standardized Payment Amount |
99083.13 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4524 |