National Provider Identifier [NPI]: |
1700847175 |
Last Name Of The Provider |
VALMADRID |
First Name Of The Provider |
CASSANDRA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD MHS |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
451 JUNCTION RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53717 |
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 |
50 |
Number Of Services |
878 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
156139 |
Total Medicare Allowed Amount |
52347.34 |
Total Medicare Payment Amount |
35004.94 |
Total Medicare Standardized Payment Amount |
36500.42 |
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 |
50 |
Number Of Medical Services |
878 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
156139 |
Total Medical Medicare Allowed Amount |
52347.34 |
Total Medical Medicare Payment Amount |
35004.94 |
Total Medical Medicare Standardized Payment Amount |
36500.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
295 |
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 |
285 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1417 |