National Provider Identifier [NPI]: |
1508087297 |
Last Name Of The Provider |
WENK |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8763 RIVER CROSSING BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW PORT RICHEY |
Zip Code Of The Provider |
346551112 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
189 |
Number Of Services |
294211 |
Number Of Medicare Beneficiaries |
699 |
Total Submitted Charge Amount |
9940601 |
Total Medicare Allowed Amount |
3939925.78 |
Total Medicare Payment Amount |
3092324.28 |
Total Medicare Standardized Payment Amount |
3087542.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
80 |
Number Of Drug Services |
280719 |
Number Of Medicare Beneficiaries With Drug Services |
261 |
Total Drug Submitted ChargeAmount |
7511080 |
Total Drug Medicare AllowedAmount |
3062547.04 |
Total Drug Medicare PaymentAmount |
2397069.36 |
Total Drug Medicare Standardized Payment Amount |
2397069.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
109 |
Number Of Medical Services |
13492 |
Number Of Medicare Beneficiaries With Medical Services |
699 |
Total Medical Submitted Charge Amount |
2429521 |
Total Medical Medicare Allowed Amount |
877378.74 |
Total Medical Medicare Payment Amount |
695254.92 |
Total Medical Medicare Standardized Payment Amount |
690473.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
258 |
Number Of Beneficiaries Age 75 to 84 |
249 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
426 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
668 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
580 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
41 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1947 |