| National Provider Identifier [NPI]: | 1528004231 |
| Last Name Of The Provider | WIRGES |
| First Name Of The Provider | CHARLOTTE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 516 W 14TH AVE |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | HOLDREGE |
| Zip Code Of The Provider | 689491216 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 3939 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 203064.68 |
| Total Medicare Allowed Amount | 119522.57 |
| Total Medicare Payment Amount | 96534.32 |
| Total Medicare Standardized Payment Amount | 103062.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 360 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 5015 |
| Total Drug Medicare AllowedAmount | 3616.39 |
| Total Drug Medicare PaymentAmount | 3405.52 |
| Total Drug Medicare Standardized Payment Amount | 3405.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 3579 |
| Number Of Medicare Beneficiaries With Medical Services | 296 |
| Total Medical Submitted Charge Amount | 198049.68 |
| Total Medical Medicare Allowed Amount | 115906.18 |
| Total Medical Medicare Payment Amount | 93128.8 |
| Total Medical Medicare Standardized Payment Amount | 99656.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 221 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0737 |