National Provider Identifier [NPI]: |
1619923406 |
Last Name Of The Provider |
SEHLOFF |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 S PARK ST |
Street Address 2 Of The Provider |
DEAN ST. MARY'S OUTPATIENT CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151830 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1944 |
Number Of Medicare Beneficiaries |
575 |
Total Submitted Charge Amount |
748532.5 |
Total Medicare Allowed Amount |
161237.01 |
Total Medicare Payment Amount |
122955.38 |
Total Medicare Standardized Payment Amount |
127504.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
421 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
24624.5 |
Total Drug Medicare AllowedAmount |
12669.78 |
Total Drug Medicare PaymentAmount |
9966.21 |
Total Drug Medicare Standardized Payment Amount |
9966.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
1523 |
Number Of Medicare Beneficiaries With Medical Services |
575 |
Total Medical Submitted Charge Amount |
723908 |
Total Medical Medicare Allowed Amount |
148567.23 |
Total Medical Medicare Payment Amount |
112989.17 |
Total Medical Medicare Standardized Payment Amount |
117538.16 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
293 |
Number Of Non Hispanic White Beneficiaries |
541 |
Number Of Black or African American Beneficiaries |
15 |
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 |
435 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7733 |