National Provider Identifier [NPI]: |
1447223037 |
Last Name Of The Provider |
STEVENSON |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 AMERICAN AVENUE 3RD FLOOR |
Street Address 2 Of The Provider |
PROHEALTH CARE MEDICAL ASSOCIATES, INC. |
City Of The Provider |
WAUKESHA |
Zip Code Of The Provider |
53188 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
627 |
Number Of Medicare Beneficiaries |
189 |
Total Submitted Charge Amount |
452894 |
Total Medicare Allowed Amount |
81755.92 |
Total Medicare Payment Amount |
62385.66 |
Total Medicare Standardized Payment Amount |
65662.75 |
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 |
48 |
Number Of Medical Services |
627 |
Number Of Medicare Beneficiaries With Medical Services |
189 |
Total Medical Submitted Charge Amount |
452894 |
Total Medical Medicare Allowed Amount |
81755.92 |
Total Medical Medicare Payment Amount |
62385.66 |
Total Medical Medicare Standardized Payment Amount |
65662.75 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
0 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9942 |