National Provider Identifier [NPI]: |
1215965892 |
Last Name Of The Provider |
BRUCKNER |
First Name Of The Provider |
JULIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3003 W GOOD HOPE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532092042 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
155 |
Number Of Services |
11450 |
Number Of Medicare Beneficiaries |
2109 |
Total Submitted Charge Amount |
2689044 |
Total Medicare Allowed Amount |
281639.77 |
Total Medicare Payment Amount |
223977.42 |
Total Medicare Standardized Payment Amount |
237791.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
8173 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
19154 |
Total Drug Medicare AllowedAmount |
2426.35 |
Total Drug Medicare PaymentAmount |
1825.23 |
Total Drug Medicare Standardized Payment Amount |
1825.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
149 |
Number Of Medical Services |
3277 |
Number Of Medicare Beneficiaries With Medical Services |
2109 |
Total Medical Submitted Charge Amount |
2669890 |
Total Medical Medicare Allowed Amount |
279213.42 |
Total Medical Medicare Payment Amount |
222152.19 |
Total Medical Medicare Standardized Payment Amount |
235966.5 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
264 |
Number Of Beneficiaries Age 65 to 74 |
1017 |
Number Of Beneficiaries Age 75 to 84 |
586 |
Number Of Beneficiaries Age Greater 84 |
242 |
Number Of Female Beneficiaries |
1547 |
Number Of Male Beneficiaries |
562 |
Number Of Non Hispanic White Beneficiaries |
1631 |
Number Of Black or African American Beneficiaries |
381 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
45 |
Number Of Beneficiaries With Medicare Only Entitlement |
1803 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
306 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0585 |