| National Provider Identifier [NPI]: | 1972702165 |
| Last Name Of The Provider | WU |
| First Name Of The Provider | SHU |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 QUEBEC AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORCORAN |
| Zip Code Of The Provider | 93212 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 223 |
| Number Of Medicare Beneficiaries | 95 |
| Total Submitted Charge Amount | 24132 |
| Total Medicare Allowed Amount | 17054.25 |
| Total Medicare Payment Amount | 11315.29 |
| Total Medicare Standardized Payment Amount | 10322.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 199 |
| Total Drug Medicare AllowedAmount | 99.93 |
| Total Drug Medicare PaymentAmount | 76.11 |
| Total Drug Medicare Standardized Payment Amount | 76.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 186 |
| Number Of Medicare Beneficiaries With Medical Services | 95 |
| Total Medical Submitted Charge Amount | 23933 |
| Total Medical Medicare Allowed Amount | 16954.32 |
| Total Medical Medicare Payment Amount | 11239.18 |
| Total Medical Medicare Standardized Payment Amount | 10246.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 30 |
| Number Of Black or African American Beneficiaries | 37 |
| 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 | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7806 |