| National Provider Identifier [NPI]: | 1699763797 |
| Last Name Of The Provider | WEN |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14419 W MCDOWELL RD |
| Street Address 2 Of The Provider | SUITE E-102 |
| City Of The Provider | GOODYEAR |
| Zip Code Of The Provider | 853952511 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1404.5 |
| Number Of Medicare Beneficiaries | 211 |
| Total Submitted Charge Amount | 152175.32 |
| Total Medicare Allowed Amount | 79298.07 |
| Total Medicare Payment Amount | 54783.54 |
| Total Medicare Standardized Payment Amount | 56304.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 315.5 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 7552 |
| Total Drug Medicare AllowedAmount | 4242.28 |
| Total Drug Medicare PaymentAmount | 3932.69 |
| Total Drug Medicare Standardized Payment Amount | 3932.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1089 |
| Number Of Medicare Beneficiaries With Medical Services | 211 |
| Total Medical Submitted Charge Amount | 144623.32 |
| Total Medical Medicare Allowed Amount | 75055.79 |
| Total Medical Medicare Payment Amount | 50850.85 |
| Total Medical Medicare Standardized Payment Amount | 52371.55 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8511 |