National Provider Identifier [NPI]: |
1710953740 |
Last Name Of The Provider |
KNOEPKE |
First Name Of The Provider |
KRISTEN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 W WASHINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537032637 |
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 |
59 |
Number Of Services |
265 |
Number Of Medicare Beneficiaries |
115 |
Total Submitted Charge Amount |
31049 |
Total Medicare Allowed Amount |
11648.78 |
Total Medicare Payment Amount |
8090.01 |
Total Medicare Standardized Payment Amount |
8671.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
526 |
Total Drug Medicare AllowedAmount |
220.16 |
Total Drug Medicare PaymentAmount |
191.21 |
Total Drug Medicare Standardized Payment Amount |
191.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
224 |
Number Of Medicare Beneficiaries With Medical Services |
115 |
Total Medical Submitted Charge Amount |
30523 |
Total Medical Medicare Allowed Amount |
11428.62 |
Total Medical Medicare Payment Amount |
7898.8 |
Total Medical Medicare Standardized Payment Amount |
8480.63 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
104 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
93 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9226 |