| National Provider Identifier [NPI]: | 1972526457 |
| Last Name Of The Provider | WU |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11370 ANDERSON ST |
| Street Address 2 Of The Provider | STE B-100 |
| City Of The Provider | LOMA LINDA |
| Zip Code Of The Provider | 923543450 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 431 |
| Number Of Medicare Beneficiaries | 92 |
| Total Submitted Charge Amount | 109107 |
| Total Medicare Allowed Amount | 38734.6 |
| Total Medicare Payment Amount | 27815 |
| Total Medicare Standardized Payment Amount | 26826.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 3746 |
| Total Drug Medicare AllowedAmount | 1280.69 |
| Total Drug Medicare PaymentAmount | 1243.05 |
| Total Drug Medicare Standardized Payment Amount | 1243.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 394 |
| Number Of Medicare Beneficiaries With Medical Services | 92 |
| Total Medical Submitted Charge Amount | 105361 |
| Total Medical Medicare Allowed Amount | 37453.91 |
| Total Medical Medicare Payment Amount | 26571.95 |
| Total Medical Medicare Standardized Payment Amount | 25583.57 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 39 |
| Number Of Non Hispanic White Beneficiaries | 54 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 25 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.447 |