National Provider Identifier [NPI]: |
1700961331 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9200 W WISCONSIN AVE |
Street Address 2 Of The Provider |
DEPT OF RADIOLOGY |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532263522 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1377 |
Number Of Medicare Beneficiaries |
1019 |
Total Submitted Charge Amount |
830464.34 |
Total Medicare Allowed Amount |
92487.27 |
Total Medicare Payment Amount |
68594.53 |
Total Medicare Standardized Payment Amount |
72609.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1377 |
Number Of Medicare Beneficiaries With Medical Services |
1019 |
Total Medical Submitted Charge Amount |
830464.34 |
Total Medical Medicare Allowed Amount |
92487.27 |
Total Medical Medicare Payment Amount |
68594.53 |
Total Medical Medicare Standardized Payment Amount |
72609.08 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
279 |
Number Of Beneficiaries Age 65 to 74 |
390 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
545 |
Number Of Male Beneficiaries |
474 |
Number Of Non Hispanic White Beneficiaries |
749 |
Number Of Black or African American Beneficiaries |
201 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
674 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
345 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.8506 |