National Provider Identifier [NPI]: |
1275586463 |
Last Name Of The Provider |
WOLFE |
First Name Of The Provider |
SHANNON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 MAPLE AVE |
Street Address 2 Of The Provider |
NW MOB SUITE 200 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232262553 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
3554 |
Number Of Medicare Beneficiaries |
592 |
Total Submitted Charge Amount |
875370.5 |
Total Medicare Allowed Amount |
258062.62 |
Total Medicare Payment Amount |
192112.3 |
Total Medicare Standardized Payment Amount |
197790.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1386 |
Number Of Medicare Beneficiaries With Drug Services |
282 |
Total Drug Submitted ChargeAmount |
55320.5 |
Total Drug Medicare AllowedAmount |
19812.76 |
Total Drug Medicare PaymentAmount |
15183.24 |
Total Drug Medicare Standardized Payment Amount |
15183.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
2168 |
Number Of Medicare Beneficiaries With Medical Services |
592 |
Total Medical Submitted Charge Amount |
820050 |
Total Medical Medicare Allowed Amount |
238249.86 |
Total Medical Medicare Payment Amount |
176929.06 |
Total Medical Medicare Standardized Payment Amount |
182607.46 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
308 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
501 |
Number Of Black or African American Beneficiaries |
73 |
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 |
552 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0265 |