National Provider Identifier [NPI]: |
1902897846 |
Last Name Of The Provider |
WHEELER |
First Name Of The Provider |
ROBERT |
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 |
13911 ST FRANCIS BLVD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
MIDLOTHIAN |
Zip Code Of The Provider |
23114 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
5845 |
Number Of Medicare Beneficiaries |
422 |
Total Submitted Charge Amount |
268894 |
Total Medicare Allowed Amount |
185185.25 |
Total Medicare Payment Amount |
141356.02 |
Total Medicare Standardized Payment Amount |
144137.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
571 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
12504 |
Total Drug Medicare AllowedAmount |
8945.95 |
Total Drug Medicare PaymentAmount |
7668.31 |
Total Drug Medicare Standardized Payment Amount |
7668.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
5274 |
Number Of Medicare Beneficiaries With Medical Services |
422 |
Total Medical Submitted Charge Amount |
256390 |
Total Medical Medicare Allowed Amount |
176239.3 |
Total Medical Medicare Payment Amount |
133687.71 |
Total Medical Medicare Standardized Payment Amount |
136469.15 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
355 |
Number Of Black or African American Beneficiaries |
45 |
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 |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1365 |