| National Provider Identifier [NPI]: | 1891868535 |
| Last Name Of The Provider | WURST |
| First Name Of The Provider | TOD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| 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 | 227 |
| Number Of Services | 4644 |
| Number Of Medicare Beneficiaries | 2953 |
| Total Submitted Charge Amount | 501096.5 |
| Total Medicare Allowed Amount | 144067.8 |
| Total Medicare Payment Amount | 109551.81 |
| Total Medicare Standardized Payment Amount | 111186.47 |
| 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 | 227 |
| Number Of Medical Services | 4644 |
| Number Of Medicare Beneficiaries With Medical Services | 2953 |
| Total Medical Submitted Charge Amount | 501096.5 |
| Total Medical Medicare Allowed Amount | 144067.8 |
| Total Medical Medicare Payment Amount | 109551.81 |
| Total Medical Medicare Standardized Payment Amount | 111186.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 556 |
| Number Of Beneficiaries Age 65 to 74 | 1002 |
| Number Of Beneficiaries Age 75 to 84 | 864 |
| Number Of Beneficiaries Age Greater 84 | 531 |
| Number Of Female Beneficiaries | 1607 |
| Number Of Male Beneficiaries | 1346 |
| Number Of Non Hispanic White Beneficiaries | 2416 |
| Number Of Black or African American Beneficiaries | 202 |
| Number Of AsianPacific Islander Beneficiaries | 155 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | 60 |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2097 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 856 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8452 |