| National Provider Identifier [NPI]: | 1205804515 |
| Last Name Of The Provider | SUCKOW |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5460 BLANDING BLVD |
| Street Address 2 Of The Provider | UFJP ANCHOR PLAZA FAMILY PRACTICE CENTER |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322441957 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 568 |
| Number Of Medicare Beneficiaries | 501 |
| Total Submitted Charge Amount | 281341 |
| Total Medicare Allowed Amount | 68274.42 |
| Total Medicare Payment Amount | 51420.57 |
| Total Medicare Standardized Payment Amount | 57469.79 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 275 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 407 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 357 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7132 |