National Provider Identifier [NPI]: |
1871553834 |
Last Name Of The Provider |
WU |
First Name Of The Provider |
DEFANG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
48073 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nuclear Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1098 |
Number Of Medicare Beneficiaries |
1029 |
Total Submitted Charge Amount |
143242 |
Total Medicare Allowed Amount |
74346.57 |
Total Medicare Payment Amount |
55411.34 |
Total Medicare Standardized Payment Amount |
53996.31 |
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 |
47 |
Number Of Medical Services |
1098 |
Number Of Medicare Beneficiaries With Medical Services |
1029 |
Total Medical Submitted Charge Amount |
143242 |
Total Medical Medicare Allowed Amount |
74346.57 |
Total Medical Medicare Payment Amount |
55411.34 |
Total Medical Medicare Standardized Payment Amount |
53996.31 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
433 |
Number Of Beneficiaries Age 75 to 84 |
334 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
649 |
Number Of Male Beneficiaries |
380 |
Number Of Non Hispanic White Beneficiaries |
795 |
Number Of Black or African American Beneficiaries |
193 |
Number Of AsianPacific Islander Beneficiaries |
26 |
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 |
851 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
31 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7244 |