National Provider Identifier [NPI]: |
1962554436 |
Last Name Of The Provider |
WU |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4660 KENMORE AVE |
Street Address 2 Of The Provider |
SUITE 1210 |
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
223041313 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
3029 |
Number Of Medicare Beneficiaries |
330 |
Total Submitted Charge Amount |
319428 |
Total Medicare Allowed Amount |
142999.84 |
Total Medicare Payment Amount |
106210.75 |
Total Medicare Standardized Payment Amount |
99253.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
74 |
Total Drug Submitted ChargeAmount |
6184 |
Total Drug Medicare AllowedAmount |
2935.17 |
Total Drug Medicare PaymentAmount |
2862.11 |
Total Drug Medicare Standardized Payment Amount |
2862.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2948 |
Number Of Medicare Beneficiaries With Medical Services |
330 |
Total Medical Submitted Charge Amount |
313244 |
Total Medical Medicare Allowed Amount |
140064.67 |
Total Medical Medicare Payment Amount |
103348.64 |
Total Medical Medicare Standardized Payment Amount |
96391.82 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
312 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9118 |