National Provider Identifier [NPI]: |
1740506948 |
Last Name Of The Provider |
BUNCE |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2801 W KINNICKINNIC RIVER PKWY |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532153669 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
450 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
102532.31 |
Total Medicare Allowed Amount |
34709.91 |
Total Medicare Payment Amount |
25166.69 |
Total Medicare Standardized Payment Amount |
26627.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1373.31 |
Total Drug Medicare AllowedAmount |
776.97 |
Total Drug Medicare PaymentAmount |
731.82 |
Total Drug Medicare Standardized Payment Amount |
731.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
425 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
101159 |
Total Medical Medicare Allowed Amount |
33932.94 |
Total Medical Medicare Payment Amount |
24434.87 |
Total Medical Medicare Standardized Payment Amount |
25895.46 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
44 |
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 |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9346 |