| National Provider Identifier [NPI]: | 1992768352 |
| Last Name Of The Provider | WENSEL |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 920 COUNTRY CLUB RD |
| Street Address 2 Of The Provider | SUITE 100A |
| City Of The Provider | EUGENE |
| Zip Code Of The Provider | 974016024 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 9421 |
| Number Of Medicare Beneficiaries | 818 |
| Total Submitted Charge Amount | 411847.6 |
| Total Medicare Allowed Amount | 121302.1 |
| Total Medicare Payment Amount | 91171.24 |
| Total Medicare Standardized Payment Amount | 95149.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 8359 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 4395.6 |
| Total Drug Medicare AllowedAmount | 2371.18 |
| Total Drug Medicare PaymentAmount | 1839.21 |
| Total Drug Medicare Standardized Payment Amount | 1839.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 1062 |
| Number Of Medicare Beneficiaries With Medical Services | 818 |
| Total Medical Submitted Charge Amount | 407452 |
| Total Medical Medicare Allowed Amount | 118930.92 |
| Total Medical Medicare Payment Amount | 89332.03 |
| Total Medical Medicare Standardized Payment Amount | 93309.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 387 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 482 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 782 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 692 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0376 |