| National Provider Identifier [NPI]: | 1295719631 |
| Last Name Of The Provider | WAGNER |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5520 GREENWICH RD |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | VIRGINIA BEACH |
| Zip Code Of The Provider | 234626541 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 24879 |
| Number Of Medicare Beneficiaries | 1952 |
| Total Submitted Charge Amount | 8578411.69 |
| Total Medicare Allowed Amount | 5078087.71 |
| Total Medicare Payment Amount | 3914343.1 |
| Total Medicare Standardized Payment Amount | 3917870.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 7443 |
| Number Of Medicare Beneficiaries With Drug Services | 696 |
| Total Drug Submitted ChargeAmount | 5727325.72 |
| Total Drug Medicare AllowedAmount | 3531399.68 |
| Total Drug Medicare PaymentAmount | 2747566.58 |
| Total Drug Medicare Standardized Payment Amount | 2747566.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 17436 |
| Number Of Medicare Beneficiaries With Medical Services | 1952 |
| Total Medical Submitted Charge Amount | 2851085.97 |
| Total Medical Medicare Allowed Amount | 1546688.03 |
| Total Medical Medicare Payment Amount | 1166776.52 |
| Total Medical Medicare Standardized Payment Amount | 1170303.45 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 632 |
| Number Of Beneficiaries Age 75 to 84 | 691 |
| Number Of Beneficiaries Age Greater 84 | 522 |
| Number Of Female Beneficiaries | 1130 |
| Number Of Male Beneficiaries | 822 |
| Number Of Non Hispanic White Beneficiaries | 1607 |
| Number Of Black or African American Beneficiaries | 256 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4347 |