National Provider Identifier [NPI]: |
1235180068 |
Last Name Of The Provider |
HOHENWALTER |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9200 W WISCONSIN AVE |
Street Address 2 Of The Provider |
DEPT OF RADIOLOGY |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532263522 |
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 |
112 |
Number Of Services |
1260 |
Number Of Medicare Beneficiaries |
959 |
Total Submitted Charge Amount |
622281 |
Total Medicare Allowed Amount |
64595.18 |
Total Medicare Payment Amount |
48821.21 |
Total Medicare Standardized Payment Amount |
51900.33 |
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 |
112 |
Number Of Medical Services |
1260 |
Number Of Medicare Beneficiaries With Medical Services |
959 |
Total Medical Submitted Charge Amount |
622281 |
Total Medical Medicare Allowed Amount |
64595.18 |
Total Medical Medicare Payment Amount |
48821.21 |
Total Medical Medicare Standardized Payment Amount |
51900.33 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
257 |
Number Of Beneficiaries Age 65 to 74 |
400 |
Number Of Beneficiaries Age 75 to 84 |
210 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
524 |
Number Of Male Beneficiaries |
435 |
Number Of Non Hispanic White Beneficiaries |
710 |
Number Of Black or African American Beneficiaries |
174 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
26 |
Number Of Beneficiaries With Medicare Only Entitlement |
698 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
261 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.1439 |