National Provider Identifier [NPI]: |
1619992781 |
Last Name Of The Provider |
WIGGINS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1303 E HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203309 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
438 |
Number Of Medicare Beneficiaries |
296 |
Total Submitted Charge Amount |
397170.51 |
Total Medicare Allowed Amount |
86982.54 |
Total Medicare Payment Amount |
67984.8 |
Total Medicare Standardized Payment Amount |
67919.85 |
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 |
62 |
Number Of Medical Services |
438 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
397170.51 |
Total Medical Medicare Allowed Amount |
86982.54 |
Total Medical Medicare Payment Amount |
67984.8 |
Total Medical Medicare Standardized Payment Amount |
67919.85 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
201 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2809 |