National Provider Identifier [NPI]: |
1770750432 |
Last Name Of The Provider |
GUGLIELMO |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537920001 |
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 |
156 |
Number Of Services |
9359 |
Number Of Medicare Beneficiaries |
2168 |
Total Submitted Charge Amount |
1261018.02 |
Total Medicare Allowed Amount |
151346.33 |
Total Medicare Payment Amount |
112448.14 |
Total Medicare Standardized Payment Amount |
118777.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
6440 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
8104.5 |
Total Drug Medicare AllowedAmount |
2003.07 |
Total Drug Medicare PaymentAmount |
1551.8 |
Total Drug Medicare Standardized Payment Amount |
1551.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
152 |
Number Of Medical Services |
2919 |
Number Of Medicare Beneficiaries With Medical Services |
2168 |
Total Medical Submitted Charge Amount |
1252913.52 |
Total Medical Medicare Allowed Amount |
149343.26 |
Total Medical Medicare Payment Amount |
110896.34 |
Total Medical Medicare Standardized Payment Amount |
117225.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
331 |
Number Of Beneficiaries Age 65 to 74 |
814 |
Number Of Beneficiaries Age 75 to 84 |
654 |
Number Of Beneficiaries Age Greater 84 |
369 |
Number Of Female Beneficiaries |
1256 |
Number Of Male Beneficiaries |
912 |
Number Of Non Hispanic White Beneficiaries |
2014 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
30 |
Number Of Beneficiaries With Medicare Only Entitlement |
1724 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
444 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4407 |