| National Provider Identifier [NPI]: | 1952685497 |
| Last Name Of The Provider | WINES |
| First Name Of The Provider | WADE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4466 W BRISTOL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485073170 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 3034 |
| Number Of Medicare Beneficiaries | 499 |
| Total Submitted Charge Amount | 335452 |
| Total Medicare Allowed Amount | 123777.22 |
| Total Medicare Payment Amount | 93268.11 |
| Total Medicare Standardized Payment Amount | 105853.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1326 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 100288 |
| Total Drug Medicare AllowedAmount | 40108.05 |
| Total Drug Medicare PaymentAmount | 30720.72 |
| Total Drug Medicare Standardized Payment Amount | 30720.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 1708 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 235164 |
| Total Medical Medicare Allowed Amount | 83669.17 |
| Total Medical Medicare Payment Amount | 62547.39 |
| Total Medical Medicare Standardized Payment Amount | 75132.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 421 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1826 |