National Provider Identifier [NPI]: |
1700981727 |
Last Name Of The Provider |
WU |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1818 E. WINDSOR RD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
URBANA |
Zip Code Of The Provider |
618029566 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
520 |
Number Of Medicare Beneficiaries |
264 |
Total Submitted Charge Amount |
99422 |
Total Medicare Allowed Amount |
40064.48 |
Total Medicare Payment Amount |
28164.92 |
Total Medicare Standardized Payment Amount |
29408.29 |
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 |
27 |
Number Of Medical Services |
520 |
Number Of Medicare Beneficiaries With Medical Services |
264 |
Total Medical Submitted Charge Amount |
99422 |
Total Medical Medicare Allowed Amount |
40064.48 |
Total Medical Medicare Payment Amount |
28164.92 |
Total Medical Medicare Standardized Payment Amount |
29408.29 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
194 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5545 |