| National Provider Identifier [NPI]: | 1124068192 |
| Last Name Of The Provider | PREIMESBERGER |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 752 N HIGH POINT RD |
| Street Address 2 Of The Provider | DEAN MEDICAL CENTER |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537172236 |
| 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 | 67 |
| Number Of Services | 565 |
| Number Of Medicare Beneficiaries | 72 |
| Total Submitted Charge Amount | 78259.32 |
| Total Medicare Allowed Amount | 20311.11 |
| Total Medicare Payment Amount | 15642.52 |
| Total Medicare Standardized Payment Amount | 16106.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1286 |
| Total Drug Medicare AllowedAmount | 672.53 |
| Total Drug Medicare PaymentAmount | 658.45 |
| Total Drug Medicare Standardized Payment Amount | 658.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 543 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 76973.32 |
| Total Medical Medicare Allowed Amount | 19638.58 |
| Total Medical Medicare Payment Amount | 14984.07 |
| Total Medical Medicare Standardized Payment Amount | 15447.89 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 23 |
| 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 | 59 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| 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 | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 17 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8025 |