National Provider Identifier [NPI]: |
1952348278 |
Last Name Of The Provider |
DALEY |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1313 FISH HATCHERY RD |
Street Address 2 Of The Provider |
DEAN MEDICAL CENTER |
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 |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
130 |
Number Of Services |
3801 |
Number Of Medicare Beneficiaries |
737 |
Total Submitted Charge Amount |
392408.36 |
Total Medicare Allowed Amount |
114549.77 |
Total Medicare Payment Amount |
89654.21 |
Total Medicare Standardized Payment Amount |
92459.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
748 |
Number Of Medicare Beneficiaries With Drug Services |
231 |
Total Drug Submitted ChargeAmount |
12182.5 |
Total Drug Medicare AllowedAmount |
7376.98 |
Total Drug Medicare PaymentAmount |
7167.54 |
Total Drug Medicare Standardized Payment Amount |
7167.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
114 |
Number Of Medical Services |
3053 |
Number Of Medicare Beneficiaries With Medical Services |
737 |
Total Medical Submitted Charge Amount |
380225.86 |
Total Medical Medicare Allowed Amount |
107172.79 |
Total Medical Medicare Payment Amount |
82486.67 |
Total Medical Medicare Standardized Payment Amount |
85291.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
353 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
470 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
669 |
Number Of Black or African American Beneficiaries |
30 |
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 |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
613 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0216 |