National Provider Identifier [NPI]: |
1285633545 |
Last Name Of The Provider |
WENDT |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 CITICO AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374041127 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
7168 |
Number Of Medicare Beneficiaries |
1489 |
Total Submitted Charge Amount |
1573825 |
Total Medicare Allowed Amount |
456806.94 |
Total Medicare Payment Amount |
333374.46 |
Total Medicare Standardized Payment Amount |
364911.86 |
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 |
85 |
Number Of Medical Services |
7168 |
Number Of Medicare Beneficiaries With Medical Services |
1489 |
Total Medical Submitted Charge Amount |
1573825 |
Total Medical Medicare Allowed Amount |
456806.94 |
Total Medical Medicare Payment Amount |
333374.46 |
Total Medical Medicare Standardized Payment Amount |
364911.86 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
470 |
Number Of Beneficiaries Age 75 to 84 |
582 |
Number Of Beneficiaries Age Greater 84 |
335 |
Number Of Female Beneficiaries |
718 |
Number Of Male Beneficiaries |
771 |
Number Of Non Hispanic White Beneficiaries |
1402 |
Number Of Black or African American Beneficiaries |
65 |
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 |
1325 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
57 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7171 |