National Provider Identifier [NPI]: |
1730131061 |
Last Name Of The Provider |
DALL |
First Name Of The Provider |
AARON |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9200 W WISCONSIN AVE |
Street Address 2 Of The Provider |
DIVISION OF NEPHROLOGY |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532263522 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1741 |
Number Of Medicare Beneficiaries |
477 |
Total Submitted Charge Amount |
1401150.11 |
Total Medicare Allowed Amount |
208926.99 |
Total Medicare Payment Amount |
162643.96 |
Total Medicare Standardized Payment Amount |
168153.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1741 |
Number Of Medicare Beneficiaries With Medical Services |
477 |
Total Medical Submitted Charge Amount |
1401150.11 |
Total Medical Medicare Allowed Amount |
208926.99 |
Total Medical Medicare Payment Amount |
162643.96 |
Total Medical Medicare Standardized Payment Amount |
168153.33 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
235 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
256 |
Number Of Black or African American Beneficiaries |
189 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
241 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
5.3243 |