National Provider Identifier [NPI]: |
1427130038 |
Last Name Of The Provider |
HERM |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
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 |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
529 |
Number Of Medicare Beneficiaries |
414 |
Total Submitted Charge Amount |
286537 |
Total Medicare Allowed Amount |
58639.77 |
Total Medicare Payment Amount |
45289.5 |
Total Medicare Standardized Payment Amount |
46931.66 |
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 |
18 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
414 |
Total Medical Submitted Charge Amount |
286537 |
Total Medical Medicare Allowed Amount |
58639.77 |
Total Medical Medicare Payment Amount |
45289.5 |
Total Medical Medicare Standardized Payment Amount |
46931.66 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
350 |
Number Of Black or African American Beneficiaries |
45 |
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 |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5063 |