| National Provider Identifier [NPI]: | 1659345478 |
| Last Name Of The Provider | WU |
| First Name Of The Provider | HERMAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1320 E DIVISION |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT VERNON |
| Zip Code Of The Provider | 982744196 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 4130 |
| Number Of Medicare Beneficiaries | 2485 |
| Total Submitted Charge Amount | 552461 |
| Total Medicare Allowed Amount | 163449.05 |
| Total Medicare Payment Amount | 126635.29 |
| Total Medicare Standardized Payment Amount | 127023.21 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 366 |
| Number Of Beneficiaries Age 65 to 74 | 1012 |
| Number Of Beneficiaries Age 75 to 84 | 726 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1577 |
| Number Of Male Beneficiaries | 908 |
| Number Of Non Hispanic White Beneficiaries | 2299 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 66 |
| Number Of American Indian Alaska Native Beneficiaries | 65 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1933 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 552 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3055 |