National Provider Identifier [NPI]: |
1720227143 |
Last Name Of The Provider |
WEI |
First Name Of The Provider |
YONGZHONG |
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 |
7530 BUCKINGHAM DR APT 2A |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLAYTON |
Zip Code Of The Provider |
631052848 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
299 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
56463 |
Total Medicare Allowed Amount |
24073.75 |
Total Medicare Payment Amount |
16087.77 |
Total Medicare Standardized Payment Amount |
21004.58 |
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 |
5 |
Number Of Medical Services |
299 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
56463 |
Total Medical Medicare Allowed Amount |
24073.75 |
Total Medical Medicare Payment Amount |
16087.77 |
Total Medical Medicare Standardized Payment Amount |
21004.58 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
207 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
12 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2982 |