National Provider Identifier [NPI]: |
1619134491 |
Last Name Of The Provider |
WILHITE |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M..D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
960 N 16TH ST |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
974774175 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
86 |
Number Of Medicare Beneficiaries |
37 |
Total Submitted Charge Amount |
37831.65 |
Total Medicare Allowed Amount |
23377.53 |
Total Medicare Payment Amount |
17799.38 |
Total Medicare Standardized Payment Amount |
19257.66 |
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 |
20 |
Number Of Medical Services |
86 |
Number Of Medicare Beneficiaries With Medical Services |
37 |
Total Medical Submitted Charge Amount |
37831.65 |
Total Medical Medicare Allowed Amount |
23377.53 |
Total Medical Medicare Payment Amount |
17799.38 |
Total Medical Medicare Standardized Payment Amount |
19257.66 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
15 |
Number Of Male Beneficiaries |
22 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.0534 |