National Provider Identifier [NPI]: |
1225023906 |
Last Name Of The Provider |
SALYAPONGSE |
First Name Of The Provider |
AMORN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
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 |
DIVISION OF HAND SURGERY |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151375 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
992 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
785417.61 |
Total Medicare Allowed Amount |
120166.27 |
Total Medicare Payment Amount |
90634.61 |
Total Medicare Standardized Payment Amount |
93830.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
241 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
3321 |
Total Drug Medicare AllowedAmount |
947.93 |
Total Drug Medicare PaymentAmount |
668.06 |
Total Drug Medicare Standardized Payment Amount |
668.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
751 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
782096.61 |
Total Medical Medicare Allowed Amount |
119218.34 |
Total Medical Medicare Payment Amount |
89966.55 |
Total Medical Medicare Standardized Payment Amount |
93162.73 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
256 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0077 |