Medicare Facts for Dr. Wendell E. Wall, MD


National Provider Identifier [NPI]: 1700812757
Last Name Of The Provider WALL
First Name Of The Provider WENDELL
Middle Initial Of The Provider A
Credentials Of The Provider MD
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 1720 HIGHWAY 59 S
Street Address 2 Of The Provider
City Of The Provider THIEF RIVER FALLS
Zip Code Of The Provider 567014331
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider Obstetrics/Gynecology
Medicare Participation Indicator Y
Number Of HCPCS 7
Number Of Services 57
Number Of Medicare Beneficiaries 13
Total Submitted Charge Amount 2883
Total Medicare Allowed Amount 2632.88
Total Medicare Payment Amount 1753.83
Total Medicare Standardized Payment Amount 1818.62
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 7
Number Of Medical Services 57
Number Of Medicare Beneficiaries With Medical Services 13
Total Medical Submitted Charge Amount 2883
Total Medical Medicare Allowed Amount 2632.88
Total Medical Medicare Payment Amount 1753.83
Total Medical Medicare Standardized Payment Amount 1818.62
Average Age Of Beneficiaries 57
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 13
Number Of Male Beneficiaries 0
Number Of Non Hispanic White Beneficiaries
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
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation
Percent Of With Alzheimers Disease or Dementia 0
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression
Percent Of With Diabetes
Percent Of With Hyperlipidemia
Percent Of With Hypertension
Percent Of With Ischemic Heart Disease 0
Percent Of With Osteoporosis 0
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders 0
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 0.8793

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