| National Provider Identifier [NPI]: | 1760694434 |
| Last Name Of The Provider | WIRSIG |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 874 PURCHASE ST |
| Street Address 2 Of The Provider | GREATER NEW BEDFORD COMMUNITY HEALTH CENTER |
| City Of The Provider | NEW BEDFORD |
| Zip Code Of The Provider | 027406232 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 268 |
| Number Of Medicare Beneficiaries | 187 |
| Total Submitted Charge Amount | 32747 |
| Total Medicare Allowed Amount | 7995.48 |
| Total Medicare Payment Amount | 5653.78 |
| Total Medicare Standardized Payment Amount | 6597.02 |
| 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 | 25 |
| Number Of Medical Services | 268 |
| Number Of Medicare Beneficiaries With Medical Services | 187 |
| Total Medical Submitted Charge Amount | 32747 |
| Total Medical Medicare Allowed Amount | 7995.48 |
| Total Medical Medicare Payment Amount | 5653.78 |
| Total Medical Medicare Standardized Payment Amount | 6597.02 |
| Average Age Of Beneficiaries | 54 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 124 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0169 |