National Provider Identifier [NPI]: |
1316989239 |
Last Name Of The Provider |
WEN |
First Name Of The Provider |
STEVE |
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 |
640 JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT PAUL |
Zip Code Of The Provider |
551012502 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
409 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
783702.8 |
Total Medicare Allowed Amount |
54983.6 |
Total Medicare Payment Amount |
42971.87 |
Total Medicare Standardized Payment Amount |
45625.17 |
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 |
81 |
Number Of Medical Services |
409 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
783702.8 |
Total Medical Medicare Allowed Amount |
54983.6 |
Total Medical Medicare Payment Amount |
42971.87 |
Total Medical Medicare Standardized Payment Amount |
45625.17 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
268 |
Number Of Black or African American Beneficiaries |
29 |
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 |
229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6444 |