National Provider Identifier [NPI]: |
1326092669 |
Last Name Of The Provider |
SCHWARTZSTEIN |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1313 FISH HATCHERY RD |
Street Address 2 Of The Provider |
DEAN CLINIC |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151911 |
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 |
52 |
Number Of Services |
186 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
25817 |
Total Medicare Allowed Amount |
8424.14 |
Total Medicare Payment Amount |
6368.88 |
Total Medicare Standardized Payment Amount |
6584.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
236 |
Total Drug Medicare AllowedAmount |
67.2 |
Total Drug Medicare PaymentAmount |
62.53 |
Total Drug Medicare Standardized Payment Amount |
62.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
161 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
25581 |
Total Medical Medicare Allowed Amount |
8356.94 |
Total Medical Medicare Payment Amount |
6306.35 |
Total Medical Medicare Standardized Payment Amount |
6521.77 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
34 |
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 |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0383 |