National Provider Identifier [NPI]: |
1083683031 |
Last Name Of The Provider |
BRODERICK |
First Name Of The Provider |
LYNN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53792 |
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 |
149 |
Number Of Services |
13522 |
Number Of Medicare Beneficiaries |
2891 |
Total Submitted Charge Amount |
1460738.5 |
Total Medicare Allowed Amount |
175967.4 |
Total Medicare Payment Amount |
129751.41 |
Total Medicare Standardized Payment Amount |
137197.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
9517 |
Number Of Medicare Beneficiaries With Drug Services |
101 |
Total Drug Submitted ChargeAmount |
10660.5 |
Total Drug Medicare AllowedAmount |
2380.17 |
Total Drug Medicare PaymentAmount |
1865.94 |
Total Drug Medicare Standardized Payment Amount |
1865.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
144 |
Number Of Medical Services |
4005 |
Number Of Medicare Beneficiaries With Medical Services |
2891 |
Total Medical Submitted Charge Amount |
1450078 |
Total Medical Medicare Allowed Amount |
173587.23 |
Total Medical Medicare Payment Amount |
127885.47 |
Total Medical Medicare Standardized Payment Amount |
135331.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
466 |
Number Of Beneficiaries Age 65 to 74 |
1087 |
Number Of Beneficiaries Age 75 to 84 |
841 |
Number Of Beneficiaries Age Greater 84 |
497 |
Number Of Female Beneficiaries |
1656 |
Number Of Male Beneficiaries |
1235 |
Number Of Non Hispanic White Beneficiaries |
2689 |
Number Of Black or African American Beneficiaries |
104 |
Number Of AsianPacific Islander Beneficiaries |
23 |
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
34 |
Number Of Beneficiaries With Medicare Only Entitlement |
2260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
631 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4296 |