National Provider Identifier [NPI]: |
1558577460 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
XU |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
444 ROXBURY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611075059 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
5246 |
Number Of Medicare Beneficiaries |
2570 |
Total Submitted Charge Amount |
824356.23 |
Total Medicare Allowed Amount |
228216.23 |
Total Medicare Payment Amount |
171583.43 |
Total Medicare Standardized Payment Amount |
176310.3 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
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 |
74 |
Number Of Beneficiaries Age Less65 |
384 |
Number Of Beneficiaries Age 65 to 74 |
909 |
Number Of Beneficiaries Age 75 to 84 |
801 |
Number Of Beneficiaries Age Greater 84 |
476 |
Number Of Female Beneficiaries |
1324 |
Number Of Male Beneficiaries |
1246 |
Number Of Non Hispanic White Beneficiaries |
2281 |
Number Of Black or African American Beneficiaries |
145 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
83 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
34 |
Number Of Beneficiaries With Medicare Only Entitlement |
1943 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
627 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7689 |