National Provider Identifier [NPI]: |
1992702914 |
Last Name Of The Provider |
WOOLF |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13102 E MISSION AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992162710 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1911 |
Number Of Medicare Beneficiaries |
368 |
Total Submitted Charge Amount |
200755 |
Total Medicare Allowed Amount |
87442.74 |
Total Medicare Payment Amount |
56691.56 |
Total Medicare Standardized Payment Amount |
57541.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
158 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
2890 |
Total Drug Medicare AllowedAmount |
2297.7 |
Total Drug Medicare PaymentAmount |
2024.52 |
Total Drug Medicare Standardized Payment Amount |
2024.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
1753 |
Number Of Medicare Beneficiaries With Medical Services |
367 |
Total Medical Submitted Charge Amount |
197865 |
Total Medical Medicare Allowed Amount |
85145.04 |
Total Medical Medicare Payment Amount |
54667.04 |
Total Medical Medicare Standardized Payment Amount |
55517.1 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
353 |
Number Of Black or African American Beneficiaries |
0 |
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 |
336 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0136 |