National Provider Identifier [NPI]: |
1548440340 |
Last Name Of The Provider |
WU |
First Name Of The Provider |
QINGXUAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11212 STATE HIGHWAY 151 |
Street Address 2 Of The Provider |
MEDICAL PLAZA 1, STE 340 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782514498 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
4832 |
Number Of Medicare Beneficiaries |
379 |
Total Submitted Charge Amount |
427972.94 |
Total Medicare Allowed Amount |
191300.62 |
Total Medicare Payment Amount |
143963.63 |
Total Medicare Standardized Payment Amount |
149780.85 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
140 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
271 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
1.986 |