National Provider Identifier [NPI]: |
1760475974 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
662 SAINT FERDINAND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLORISSANT |
Zip Code Of The Provider |
630315125 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
3774 |
Number Of Medicare Beneficiaries |
670 |
Total Submitted Charge Amount |
255809 |
Total Medicare Allowed Amount |
191431.75 |
Total Medicare Payment Amount |
136624.53 |
Total Medicare Standardized Payment Amount |
141410.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
221 |
Number Of Medicare Beneficiaries With Drug Services |
123 |
Total Drug Submitted ChargeAmount |
663 |
Total Drug Medicare AllowedAmount |
393.75 |
Total Drug Medicare PaymentAmount |
299.96 |
Total Drug Medicare Standardized Payment Amount |
299.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
3553 |
Number Of Medicare Beneficiaries With Medical Services |
670 |
Total Medical Submitted Charge Amount |
255146 |
Total Medical Medicare Allowed Amount |
191038 |
Total Medical Medicare Payment Amount |
136324.57 |
Total Medical Medicare Standardized Payment Amount |
141110.25 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
215 |
Number Of Beneficiaries Age Greater 84 |
184 |
Number Of Female Beneficiaries |
406 |
Number Of Male Beneficiaries |
264 |
Number Of Non Hispanic White Beneficiaries |
531 |
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 |
597 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5394 |