National Provider Identifier [NPI]: |
1487691705 |
Last Name Of The Provider |
EICHHORN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 S PARK ST |
Street Address 2 Of The Provider |
ST MARYS HOSPITAL DEAN MEDICAL CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151849 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1007 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
320974 |
Total Medicare Allowed Amount |
93228.95 |
Total Medicare Payment Amount |
72713.37 |
Total Medicare Standardized Payment Amount |
75094.94 |
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 |
21 |
Number Of Medical Services |
1007 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
320974 |
Total Medical Medicare Allowed Amount |
93228.95 |
Total Medical Medicare Payment Amount |
72713.37 |
Total Medical Medicare Standardized Payment Amount |
75094.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
418 |
Number Of Black or African American Beneficiaries |
17 |
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 |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9031 |