National Provider Identifier [NPI]: |
1659398394 |
Last Name Of The Provider |
WANGSNES |
First Name Of The Provider |
KRAIG |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1348 WALTON WAY |
Street Address 2 Of The Provider |
SUITE 5100 |
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309015104 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
95 |
Number Of Services |
3438 |
Number Of Medicare Beneficiaries |
1023 |
Total Submitted Charge Amount |
1003536.5 |
Total Medicare Allowed Amount |
283690.32 |
Total Medicare Payment Amount |
209303.1 |
Total Medicare Standardized Payment Amount |
220540.53 |
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 |
95 |
Number Of Medical Services |
3438 |
Number Of Medicare Beneficiaries With Medical Services |
1023 |
Total Medical Submitted Charge Amount |
1003536.5 |
Total Medical Medicare Allowed Amount |
283690.32 |
Total Medical Medicare Payment Amount |
209303.1 |
Total Medical Medicare Standardized Payment Amount |
220540.53 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
420 |
Number Of Beneficiaries Age 75 to 84 |
366 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
513 |
Number Of Male Beneficiaries |
510 |
Number Of Non Hispanic White Beneficiaries |
860 |
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 |
882 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5751 |