Medicare Facts for Dr. Jessica A. Wentzell, OD


National Provider Identifier [NPI]: 1447280847
Last Name Of The Provider WENTZELL
First Name Of The Provider JESSICA
Middle Initial Of The Provider A
Credentials Of The Provider OD
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 101 WILLMAR AVE SW
Street Address 2 Of The Provider AFFILIATED COMMUNITY MEDICAL CENTERS
City Of The Provider WILLMAR
Zip Code Of The Provider 56201
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider Optometry
Medicare Participation Indicator Y
Number Of HCPCS 12
Number Of Services 287
Number Of Medicare Beneficiaries 154
Total Submitted Charge Amount 36648.45
Total Medicare Allowed Amount 27890.21
Total Medicare Payment Amount 17530.2
Total Medicare Standardized Payment Amount 18145.79
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 0
Number Of Drug Services 0
Number Of Medicare Beneficiaries With Drug Services 0
Total Drug Submitted ChargeAmount 0
Total Drug Medicare AllowedAmount 0
Total Drug Medicare PaymentAmount 0
Total Drug Medicare Standardized Payment Amount 0
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 12
Number Of Medical Services 287
Number Of Medicare Beneficiaries With Medical Services 154
Total Medical Submitted Charge Amount 36648.45
Total Medical Medicare Allowed Amount 27890.21
Total Medical Medicare Payment Amount 17530.2
Total Medical Medicare Standardized Payment Amount 18145.79
Average Age Of Beneficiaries 70
Number Of Beneficiaries Age Less65 41
Number Of Beneficiaries Age 65 to 74 47
Number Of Beneficiaries Age 75 to 84 40
Number Of Beneficiaries Age Greater 84 26
Number Of Female Beneficiaries 91
Number Of Male Beneficiaries 63
Number Of Non Hispanic White Beneficiaries
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 110
Number Of Beneficiaries With Medicare Medicaid Entitlement 44
Percent Of With Atrial Fibrillation 9
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure 11
Percent Of With Chronic Kidney Disease 12
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 16
Percent Of With Diabetes 28
Percent Of With Hyperlipidemia 34
Percent Of With Hypertension 40
Percent Of With Ischemic Heart Disease 18
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 29
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 0.8616

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