National Provider Identifier [NPI]: |
1821063637 |
Last Name Of The Provider |
TODD |
First Name Of The Provider |
PAUL |
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 |
N91W17271 APPLETON AVE |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
MENOMONEE FALLS |
Zip Code Of The Provider |
530512045 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1387 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
379998.27 |
Total Medicare Allowed Amount |
112284.25 |
Total Medicare Payment Amount |
80979.33 |
Total Medicare Standardized Payment Amount |
85775.9 |
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 |
16 |
Number Of Medical Services |
1387 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
379998.27 |
Total Medical Medicare Allowed Amount |
112284.25 |
Total Medical Medicare Payment Amount |
80979.33 |
Total Medical Medicare Standardized Payment Amount |
85775.9 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
215 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2456 |