National Provider Identifier [NPI]: |
1598701278 |
Last Name Of The Provider |
WELCH |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
J |
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 |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
151896 |
Total Medicare Allowed Amount |
18822.16 |
Total Medicare Payment Amount |
12787 |
Total Medicare Standardized Payment Amount |
14528.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
162 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
3033 |
Total Drug Medicare AllowedAmount |
855.54 |
Total Drug Medicare PaymentAmount |
609.99 |
Total Drug Medicare Standardized Payment Amount |
609.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
113 |
Number Of Medicare Beneficiaries With Medical Services |
64 |
Total Medical Submitted Charge Amount |
148863 |
Total Medical Medicare Allowed Amount |
17966.62 |
Total Medical Medicare Payment Amount |
12177.01 |
Total Medical Medicare Standardized Payment Amount |
13918.9 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
22 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
33 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.1886 |