National Provider Identifier [NPI]: |
1245246198 |
Last Name Of The Provider |
KIND |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 11TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONROE |
Zip Code Of The Provider |
535661747 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
4234 |
Number Of Medicare Beneficiaries |
1167 |
Total Submitted Charge Amount |
542210.7 |
Total Medicare Allowed Amount |
243867.49 |
Total Medicare Payment Amount |
175433.66 |
Total Medicare Standardized Payment Amount |
182626.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
299 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
15470 |
Total Drug Medicare AllowedAmount |
9208.99 |
Total Drug Medicare PaymentAmount |
7204.17 |
Total Drug Medicare Standardized Payment Amount |
7204.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3935 |
Number Of Medicare Beneficiaries With Medical Services |
1167 |
Total Medical Submitted Charge Amount |
526740.7 |
Total Medical Medicare Allowed Amount |
234658.5 |
Total Medical Medicare Payment Amount |
168229.49 |
Total Medical Medicare Standardized Payment Amount |
175422.53 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
371 |
Number Of Beneficiaries Age Greater 84 |
339 |
Number Of Female Beneficiaries |
711 |
Number Of Male Beneficiaries |
456 |
Number Of Non Hispanic White Beneficiaries |
1097 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
911 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3383 |