National Provider Identifier [NPI]: |
1649431693 |
Last Name Of The Provider |
WOLFER |
First Name Of The Provider |
VIKTORIYA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10150 SE 32ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKIE |
Zip Code Of The Provider |
972226516 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
468 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
105959 |
Total Medicare Allowed Amount |
54108.96 |
Total Medicare Payment Amount |
41269.39 |
Total Medicare Standardized Payment Amount |
40889.56 |
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 |
21 |
Number Of Medical Services |
468 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
105959 |
Total Medical Medicare Allowed Amount |
54108.96 |
Total Medical Medicare Payment Amount |
41269.39 |
Total Medical Medicare Standardized Payment Amount |
40889.56 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
121 |
Number Of Black or African American Beneficiaries |
46 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.1922 |