| National Provider Identifier [NPI]: | 1275525909 |
| Last Name Of The Provider | WESSEL |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6354 W FORT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482092941 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 704 |
| Number Of Medicare Beneficiaries | 122 |
| Total Submitted Charge Amount | 46298 |
| Total Medicare Allowed Amount | 35209.53 |
| Total Medicare Payment Amount | 26426.19 |
| Total Medicare Standardized Payment Amount | 25807.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 686 |
| Total Drug Medicare AllowedAmount | 141.69 |
| Total Drug Medicare PaymentAmount | 132.57 |
| Total Drug Medicare Standardized Payment Amount | 132.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 624 |
| Number Of Medicare Beneficiaries With Medical Services | 122 |
| Total Medical Submitted Charge Amount | 45612 |
| Total Medical Medicare Allowed Amount | 35067.84 |
| Total Medical Medicare Payment Amount | 26293.62 |
| Total Medical Medicare Standardized Payment Amount | 25675.12 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 60 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1971 |