National Provider Identifier [NPI]: |
1194846964 |
Last Name Of The Provider |
GOESSL |
First Name Of The Provider |
MARIO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
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 |
SUITE A |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151830 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
97 |
Number Of Services |
1624 |
Number Of Medicare Beneficiaries |
681 |
Total Submitted Charge Amount |
970238 |
Total Medicare Allowed Amount |
129664.94 |
Total Medicare Payment Amount |
99131.61 |
Total Medicare Standardized Payment Amount |
104092.65 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
250 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
367 |
Number Of Non Hispanic White Beneficiaries |
650 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
570 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3979 |