National Provider Identifier [NPI]: |
1275775744 |
Last Name Of The Provider |
HARDY |
First Name Of The Provider |
ERIK |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
202 S PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151507 |
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 |
22 |
Number Of Services |
634 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
200026 |
Total Medicare Allowed Amount |
60921.83 |
Total Medicare Payment Amount |
47234.98 |
Total Medicare Standardized Payment Amount |
48977.11 |
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 |
22 |
Number Of Medical Services |
634 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
200026 |
Total Medical Medicare Allowed Amount |
60921.83 |
Total Medical Medicare Payment Amount |
47234.98 |
Total Medical Medicare Standardized Payment Amount |
48977.11 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
115 |
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 |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.033 |