| National Provider Identifier [NPI]: | 1578552618 |
| Last Name Of The Provider | WEHN |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2323 W ROSE GARDEN LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850272530 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 12003 |
| Number Of Medicare Beneficiaries | 3231 |
| Total Submitted Charge Amount | 1041677 |
| Total Medicare Allowed Amount | 245790.89 |
| Total Medicare Payment Amount | 183617.6 |
| Total Medicare Standardized Payment Amount | 187961.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7002 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 14202 |
| Total Drug Medicare AllowedAmount | 2397.44 |
| Total Drug Medicare PaymentAmount | 1858.57 |
| Total Drug Medicare Standardized Payment Amount | 1858.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 5001 |
| Number Of Medicare Beneficiaries With Medical Services | 3231 |
| Total Medical Submitted Charge Amount | 1027475 |
| Total Medical Medicare Allowed Amount | 243393.45 |
| Total Medical Medicare Payment Amount | 181759.03 |
| Total Medical Medicare Standardized Payment Amount | 186102.77 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 550 |
| Number Of Beneficiaries Age 65 to 74 | 1495 |
| Number Of Beneficiaries Age 75 to 84 | 876 |
| Number Of Beneficiaries Age Greater 84 | 310 |
| Number Of Female Beneficiaries | 1903 |
| Number Of Male Beneficiaries | 1328 |
| Number Of Non Hispanic White Beneficiaries | 2388 |
| Number Of Black or African American Beneficiaries | 227 |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | 456 |
| Number Of American Indian Alaska Native Beneficiaries | 41 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2555 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 676 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7286 |