| National Provider Identifier [NPI]: | 1770741399 |
| Last Name Of The Provider | WENNERSTROM |
| First Name Of The Provider | CAREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1337 S FOUNTAIN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLATHE |
| Zip Code Of The Provider | 660617205 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 373 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 30712.93 |
| Total Medicare Allowed Amount | 26046.13 |
| Total Medicare Payment Amount | 19043.11 |
| Total Medicare Standardized Payment Amount | 20974.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 269 |
| Total Drug Medicare AllowedAmount | 40.58 |
| Total Drug Medicare PaymentAmount | 30.22 |
| Total Drug Medicare Standardized Payment Amount | 30.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 357 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 30443.93 |
| Total Medical Medicare Allowed Amount | 26005.55 |
| Total Medical Medicare Payment Amount | 19012.89 |
| Total Medical Medicare Standardized Payment Amount | 20944.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7607 |