| National Provider Identifier [NPI]: | 1073560876 |
| Last Name Of The Provider | WESENBERG |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 NE MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016051 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 2666 |
| Number Of Medicare Beneficiaries | 734 |
| Total Submitted Charge Amount | 185540.14 |
| Total Medicare Allowed Amount | 58837.09 |
| Total Medicare Payment Amount | 44466.43 |
| Total Medicare Standardized Payment Amount | 45576.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 27 |
| Number Of Drug Services | 519 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 10013.9 |
| Total Drug Medicare AllowedAmount | 2724.47 |
| Total Drug Medicare PaymentAmount | 2129.59 |
| Total Drug Medicare Standardized Payment Amount | 2129.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 2147 |
| Number Of Medicare Beneficiaries With Medical Services | 734 |
| Total Medical Submitted Charge Amount | 175526.24 |
| Total Medical Medicare Allowed Amount | 56112.62 |
| Total Medical Medicare Payment Amount | 42336.84 |
| Total Medical Medicare Standardized Payment Amount | 43446.81 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 369 |
| Number Of Male Beneficiaries | 365 |
| Number Of Non Hispanic White Beneficiaries | 708 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 668 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 41 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2781 |