National Provider Identifier [NPI]: |
1609821826 |
Last Name Of The Provider |
TOBAR |
First Name Of The Provider |
ADRIANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 E RACINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JANESVILLE |
Zip Code Of The Provider |
535462343 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
2368 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
317605.8 |
Total Medicare Allowed Amount |
81626.75 |
Total Medicare Payment Amount |
62948.47 |
Total Medicare Standardized Payment Amount |
64877.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
165 |
Number Of Medicare Beneficiaries With Drug Services |
75 |
Total Drug Submitted ChargeAmount |
6583 |
Total Drug Medicare AllowedAmount |
3773.66 |
Total Drug Medicare PaymentAmount |
3362.57 |
Total Drug Medicare Standardized Payment Amount |
3362.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
101 |
Number Of Medical Services |
2203 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
311022.8 |
Total Medical Medicare Allowed Amount |
77853.09 |
Total Medical Medicare Payment Amount |
59585.9 |
Total Medical Medicare Standardized Payment Amount |
61515.26 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.947 |