National Provider Identifier [NPI]: |
1114143286 |
Last Name Of The Provider |
WEHLING |
First Name Of The Provider |
EDWIN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13355 E 10 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480892048 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
147 |
Number Of Services |
689 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
437701 |
Total Medicare Allowed Amount |
196626.18 |
Total Medicare Payment Amount |
150446.3 |
Total Medicare Standardized Payment Amount |
154147.73 |
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 |
147 |
Number Of Medical Services |
689 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
437701 |
Total Medical Medicare Allowed Amount |
196626.18 |
Total Medical Medicare Payment Amount |
150446.3 |
Total Medical Medicare Standardized Payment Amount |
154147.73 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.76 |