| National Provider Identifier [NPI]: | 1104969609 |
| Last Name Of The Provider | WIEMKEN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16000 PEARL RD STE 105 |
| Street Address 2 Of The Provider | |
| City Of The Provider | STRONGSVILLE |
| Zip Code Of The Provider | 441366094 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3902 |
| Number Of Medicare Beneficiaries | 778 |
| Total Submitted Charge Amount | 239051.99 |
| Total Medicare Allowed Amount | 186248.36 |
| Total Medicare Payment Amount | 130660.94 |
| Total Medicare Standardized Payment Amount | 137861.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 153 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 954 |
| Total Drug Medicare AllowedAmount | 272.41 |
| Total Drug Medicare PaymentAmount | 203.54 |
| Total Drug Medicare Standardized Payment Amount | 203.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 3749 |
| Number Of Medicare Beneficiaries With Medical Services | 778 |
| Total Medical Submitted Charge Amount | 238097.99 |
| Total Medical Medicare Allowed Amount | 185975.95 |
| Total Medical Medicare Payment Amount | 130457.4 |
| Total Medical Medicare Standardized Payment Amount | 137657.72 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 351 |
| Number Of Female Beneficiaries | 507 |
| Number Of Male Beneficiaries | 271 |
| Number Of Non Hispanic White Beneficiaries | 752 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| 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 | 635 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6688 |