National Provider Identifier [NPI]: |
1881745917 |
Last Name Of The Provider |
WOOFTER |
First Name Of The Provider |
MELINDA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1959 NEWARK-GRANVILLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRANVILLE |
Zip Code Of The Provider |
43023 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
3728 |
Number Of Medicare Beneficiaries |
538 |
Total Submitted Charge Amount |
520609.45 |
Total Medicare Allowed Amount |
332342.35 |
Total Medicare Payment Amount |
249703.92 |
Total Medicare Standardized Payment Amount |
255076.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
111 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
44272 |
Total Drug Medicare AllowedAmount |
27452.86 |
Total Drug Medicare PaymentAmount |
21347.5 |
Total Drug Medicare Standardized Payment Amount |
21347.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
3617 |
Number Of Medicare Beneficiaries With Medical Services |
538 |
Total Medical Submitted Charge Amount |
476337.45 |
Total Medical Medicare Allowed Amount |
304889.49 |
Total Medical Medicare Payment Amount |
228356.42 |
Total Medical Medicare Standardized Payment Amount |
233729.15 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
97 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
239 |
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 |
519 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9697 |