National Provider Identifier [NPI]: |
1518036433 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
RUILIN |
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 |
4424 S 86TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685269225 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1427 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
146235.36 |
Total Medicare Allowed Amount |
91153.76 |
Total Medicare Payment Amount |
63804.59 |
Total Medicare Standardized Payment Amount |
69983.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
86 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
1791 |
Total Drug Medicare AllowedAmount |
1480.02 |
Total Drug Medicare PaymentAmount |
1428.79 |
Total Drug Medicare Standardized Payment Amount |
1428.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1341 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
144444.36 |
Total Medical Medicare Allowed Amount |
89673.74 |
Total Medical Medicare Payment Amount |
62375.8 |
Total Medical Medicare Standardized Payment Amount |
68554.81 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
376 |
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 |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2112 |