National Provider Identifier [NPI]: |
1205823317 |
Last Name Of The Provider |
FERGUSON |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537920001 |
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 |
45 |
Number Of Services |
1108 |
Number Of Medicare Beneficiaries |
400 |
Total Submitted Charge Amount |
587767 |
Total Medicare Allowed Amount |
72345.95 |
Total Medicare Payment Amount |
55709.86 |
Total Medicare Standardized Payment Amount |
57825 |
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 |
45 |
Number Of Medical Services |
1108 |
Number Of Medicare Beneficiaries With Medical Services |
400 |
Total Medical Submitted Charge Amount |
587767 |
Total Medical Medicare Allowed Amount |
72345.95 |
Total Medical Medicare Payment Amount |
55709.86 |
Total Medical Medicare Standardized Payment Amount |
57825 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
373 |
Number Of Black or African American Beneficiaries |
11 |
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 |
323 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
54 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.952 |