National Provider Identifier [NPI]: |
1053398040 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28 RIVERSIDE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEMBROKE |
Zip Code Of The Provider |
023591937 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
846 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
131030 |
Total Medicare Allowed Amount |
62580.14 |
Total Medicare Payment Amount |
51705.1 |
Total Medicare Standardized Payment Amount |
50100.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
6398 |
Total Drug Medicare AllowedAmount |
4513.62 |
Total Drug Medicare PaymentAmount |
4406.31 |
Total Drug Medicare Standardized Payment Amount |
4406.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
730 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
124632 |
Total Medical Medicare Allowed Amount |
58066.52 |
Total Medical Medicare Payment Amount |
47298.79 |
Total Medical Medicare Standardized Payment Amount |
45694.23 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
49 |
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 |
203 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9183 |