National Provider Identifier [NPI]: |
1770506479 |
Last Name Of The Provider |
WILKES |
First Name Of The Provider |
SHELBY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
830 W PEACHTREE ST NW |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303081129 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1247 |
Number Of Medicare Beneficiaries |
236 |
Total Submitted Charge Amount |
272580 |
Total Medicare Allowed Amount |
116470.21 |
Total Medicare Payment Amount |
87535.45 |
Total Medicare Standardized Payment Amount |
91819.61 |
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 |
35 |
Number Of Medical Services |
1247 |
Number Of Medicare Beneficiaries With Medical Services |
236 |
Total Medical Submitted Charge Amount |
272580 |
Total Medical Medicare Allowed Amount |
116470.21 |
Total Medical Medicare Payment Amount |
87535.45 |
Total Medical Medicare Standardized Payment Amount |
91819.61 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
220 |
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 |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5361 |