National Provider Identifier [NPI]: |
1508885229 |
Last Name Of The Provider |
WU |
First Name Of The Provider |
JOSEPHINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 S CALIFORNIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606081732 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
189 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
247940.91 |
Total Medicare Allowed Amount |
26468.46 |
Total Medicare Payment Amount |
20639.35 |
Total Medicare Standardized Payment Amount |
18553.87 |
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 |
51 |
Number Of Medical Services |
189 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
247940.91 |
Total Medical Medicare Allowed Amount |
26468.46 |
Total Medical Medicare Payment Amount |
20639.35 |
Total Medical Medicare Standardized Payment Amount |
18553.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
100 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5901 |