National Provider Identifier [NPI]: |
1295779064 |
Last Name Of The Provider |
BRECKBILL |
First Name Of The Provider |
DON |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1821 S STOUGHTON RD |
Street Address 2 Of The Provider |
DEAN MEDICAL CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537162257 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
139 |
Number Of Services |
5677 |
Number Of Medicare Beneficiaries |
923 |
Total Submitted Charge Amount |
256839 |
Total Medicare Allowed Amount |
56773.95 |
Total Medicare Payment Amount |
44725.51 |
Total Medicare Standardized Payment Amount |
45977.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
3376 |
Number Of Medicare Beneficiaries With Drug Services |
149 |
Total Drug Submitted ChargeAmount |
14667 |
Total Drug Medicare AllowedAmount |
6105.63 |
Total Drug Medicare PaymentAmount |
5070.8 |
Total Drug Medicare Standardized Payment Amount |
5070.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
118 |
Number Of Medical Services |
2301 |
Number Of Medicare Beneficiaries With Medical Services |
922 |
Total Medical Submitted Charge Amount |
242172 |
Total Medical Medicare Allowed Amount |
50668.32 |
Total Medical Medicare Payment Amount |
39654.71 |
Total Medical Medicare Standardized Payment Amount |
40906.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
385 |
Number Of Beneficiaries Age 75 to 84 |
259 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
533 |
Number Of Male Beneficiaries |
390 |
Number Of Non Hispanic White Beneficiaries |
846 |
Number Of Black or African American Beneficiaries |
44 |
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 |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
776 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.084 |