| National Provider Identifier [NPI]: | 1013988633 |
| Last Name Of The Provider | WIENKE |
| First Name Of The Provider | JUDITH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1241 W STADIUM BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JEFFERSON CITY |
| Zip Code Of The Provider | 651096023 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 5701 |
| Number Of Medicare Beneficiaries | 489 |
| Total Submitted Charge Amount | 151226 |
| Total Medicare Allowed Amount | 73822.84 |
| Total Medicare Payment Amount | 58243.1 |
| Total Medicare Standardized Payment Amount | 70038.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 3564 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 13139 |
| Total Drug Medicare AllowedAmount | 6219.65 |
| Total Drug Medicare PaymentAmount | 5611.04 |
| Total Drug Medicare Standardized Payment Amount | 5611.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 2137 |
| Number Of Medicare Beneficiaries With Medical Services | 489 |
| Total Medical Submitted Charge Amount | 138087 |
| Total Medical Medicare Allowed Amount | 67603.19 |
| Total Medical Medicare Payment Amount | 52632.06 |
| Total Medical Medicare Standardized Payment Amount | 64427.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| 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 | 429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9652 |