| National Provider Identifier [NPI]: | 1790955342 |
| Last Name Of The Provider | WIECZOREK |
| First Name Of The Provider | CHERYL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | CRNP, MSN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 E LANCASTER AVE |
| Street Address 2 Of The Provider | SUITE 137 LANKENAU MED BLDG |
| City Of The Provider | WYNNEWOOD |
| Zip Code Of The Provider | 190963450 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 46897 |
| Number Of Medicare Beneficiaries | 513 |
| Total Submitted Charge Amount | 1289346.88 |
| Total Medicare Allowed Amount | 805036.04 |
| Total Medicare Payment Amount | 624796.06 |
| Total Medicare Standardized Payment Amount | 635313.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 44903 |
| Number Of Medicare Beneficiaries With Drug Services | 392 |
| Total Drug Submitted ChargeAmount | 999480.88 |
| Total Drug Medicare AllowedAmount | 637372.07 |
| Total Drug Medicare PaymentAmount | 499601.99 |
| Total Drug Medicare Standardized Payment Amount | 499601.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1994 |
| Number Of Medicare Beneficiaries With Medical Services | 513 |
| Total Medical Submitted Charge Amount | 289866 |
| Total Medical Medicare Allowed Amount | 167663.97 |
| Total Medical Medicare Payment Amount | 125194.07 |
| Total Medical Medicare Standardized Payment Amount | 135711.17 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 190 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 426 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | 428 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 63 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3053 |