National Provider Identifier [NPI]: |
1679538201 |
Last Name Of The Provider |
STOECKER |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 S PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53715 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
309 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
169217 |
Total Medicare Allowed Amount |
17719.46 |
Total Medicare Payment Amount |
13026.93 |
Total Medicare Standardized Payment Amount |
15777.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
358 |
Total Drug Medicare AllowedAmount |
125.74 |
Total Drug Medicare PaymentAmount |
89.54 |
Total Drug Medicare Standardized Payment Amount |
89.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
287 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
168859 |
Total Medical Medicare Allowed Amount |
17593.72 |
Total Medical Medicare Payment Amount |
12937.39 |
Total Medical Medicare Standardized Payment Amount |
15687.67 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
29 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0892 |