National Provider Identifier [NPI]: |
1508869587 |
Last Name Of The Provider |
LAWTON |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2020 RIVERSIDE DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
GREEN BAY |
Zip Code Of The Provider |
543012300 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1339 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
700131.5 |
Total Medicare Allowed Amount |
291693.09 |
Total Medicare Payment Amount |
228212.56 |
Total Medicare Standardized Payment Amount |
235719.19 |
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 |
12 |
Number Of Medical Services |
1339 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
700131.5 |
Total Medical Medicare Allowed Amount |
291693.09 |
Total Medical Medicare Payment Amount |
228212.56 |
Total Medical Medicare Standardized Payment Amount |
235719.19 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
37 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
6.5134 |