National Provider Identifier [NPI]: |
1962464123 |
Last Name Of The Provider |
PICKHARDT |
First Name Of The Provider |
PERRY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
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 |
72 |
Number Of Services |
2692 |
Number Of Medicare Beneficiaries |
920 |
Total Submitted Charge Amount |
526287.2 |
Total Medicare Allowed Amount |
70504.89 |
Total Medicare Payment Amount |
54442.82 |
Total Medicare Standardized Payment Amount |
56929.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
1410 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
4479 |
Total Drug Medicare AllowedAmount |
258.7 |
Total Drug Medicare PaymentAmount |
202.8 |
Total Drug Medicare Standardized Payment Amount |
202.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
1282 |
Number Of Medicare Beneficiaries With Medical Services |
920 |
Total Medical Submitted Charge Amount |
521808.2 |
Total Medical Medicare Allowed Amount |
70246.19 |
Total Medical Medicare Payment Amount |
54240.02 |
Total Medical Medicare Standardized Payment Amount |
56726.69 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
259 |
Number Of Beneficiaries Age 65 to 74 |
384 |
Number Of Beneficiaries Age 75 to 84 |
197 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
462 |
Number Of Male Beneficiaries |
458 |
Number Of Non Hispanic White Beneficiaries |
837 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
674 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
246 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.0603 |