National Provider Identifier [NPI]: |
1831206887 |
Last Name Of The Provider |
WEBBER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
248 MCHENRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
53105 |
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 |
105 |
Number Of Services |
4621.6 |
Number Of Medicare Beneficiaries |
504 |
Total Submitted Charge Amount |
659477.23 |
Total Medicare Allowed Amount |
194570.39 |
Total Medicare Payment Amount |
148683.35 |
Total Medicare Standardized Payment Amount |
154119.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
25 |
Number Of Drug Services |
1969.6 |
Number Of Medicare Beneficiaries With Drug Services |
322 |
Total Drug Submitted ChargeAmount |
107325.23 |
Total Drug Medicare AllowedAmount |
34998.15 |
Total Drug Medicare PaymentAmount |
28192.81 |
Total Drug Medicare Standardized Payment Amount |
28192.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
2652 |
Number Of Medicare Beneficiaries With Medical Services |
502 |
Total Medical Submitted Charge Amount |
552152 |
Total Medical Medicare Allowed Amount |
159572.24 |
Total Medical Medicare Payment Amount |
120490.54 |
Total Medical Medicare Standardized Payment Amount |
125926.46 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
488 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
474 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.8803 |