| National Provider Identifier [NPI]: | 1982662623 |
| Last Name Of The Provider | WEN |
| First Name Of The Provider | TED |
| 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 | 6200 W PARKER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750937939 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 6792 |
| Number Of Medicare Beneficiaries | 4821 |
| Total Submitted Charge Amount | 834001.97 |
| Total Medicare Allowed Amount | 178377.96 |
| Total Medicare Payment Amount | 137994.37 |
| Total Medicare Standardized Payment Amount | 143287.78 |
| 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 | 193 |
| Number Of Medical Services | 6792 |
| Number Of Medicare Beneficiaries With Medical Services | 4821 |
| Total Medical Submitted Charge Amount | 834001.97 |
| Total Medical Medicare Allowed Amount | 178377.96 |
| Total Medical Medicare Payment Amount | 137994.37 |
| Total Medical Medicare Standardized Payment Amount | 143287.78 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 715 |
| Number Of Beneficiaries Age 65 to 74 | 1810 |
| Number Of Beneficiaries Age 75 to 84 | 1483 |
| Number Of Beneficiaries Age Greater 84 | 813 |
| Number Of Female Beneficiaries | 2958 |
| Number Of Male Beneficiaries | 1863 |
| Number Of Non Hispanic White Beneficiaries | 4091 |
| Number Of Black or African American Beneficiaries | 290 |
| Number Of AsianPacific Islander Beneficiaries | 128 |
| Number Of Hispanic Beneficiaries | 230 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3835 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 986 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8421 |