National Provider Identifier [NPI]: |
1174585582 |
Last Name Of The Provider |
FIELD |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 W BROWN DEER RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
BAYSIDE |
Zip Code Of The Provider |
532171618 |
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 |
99 |
Number Of Services |
2864 |
Number Of Medicare Beneficiaries |
1738 |
Total Submitted Charge Amount |
413073.67 |
Total Medicare Allowed Amount |
78423.38 |
Total Medicare Payment Amount |
66589.17 |
Total Medicare Standardized Payment Amount |
69398.99 |
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 |
99 |
Number Of Medical Services |
2864 |
Number Of Medicare Beneficiaries With Medical Services |
1738 |
Total Medical Submitted Charge Amount |
413073.67 |
Total Medical Medicare Allowed Amount |
78423.38 |
Total Medical Medicare Payment Amount |
66589.17 |
Total Medical Medicare Standardized Payment Amount |
69398.99 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
708 |
Number Of Beneficiaries Age 75 to 84 |
525 |
Number Of Beneficiaries Age Greater 84 |
299 |
Number Of Female Beneficiaries |
1327 |
Number Of Male Beneficiaries |
411 |
Number Of Non Hispanic White Beneficiaries |
1472 |
Number Of Black or African American Beneficiaries |
187 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
1431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
307 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3488 |