National Provider Identifier [NPI]: |
1346216371 |
Last Name Of The Provider |
MALONE |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
705 S UNIVERSITY AVE |
Street Address 2 Of The Provider |
STE 150 |
City Of The Provider |
BEAVER DAM |
Zip Code Of The Provider |
539163053 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
494 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
118552.92 |
Total Medicare Allowed Amount |
22211.15 |
Total Medicare Payment Amount |
14925.82 |
Total Medicare Standardized Payment Amount |
16447.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
213 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
4773.75 |
Total Drug Medicare AllowedAmount |
2074.72 |
Total Drug Medicare PaymentAmount |
1616.92 |
Total Drug Medicare Standardized Payment Amount |
1616.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
281 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
113779.17 |
Total Medical Medicare Allowed Amount |
20136.43 |
Total Medical Medicare Payment Amount |
13308.9 |
Total Medical Medicare Standardized Payment Amount |
14830.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1044 |