National Provider Identifier [NPI]: |
1013944891 |
Last Name Of The Provider |
SARNWICK |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1346 E GREEN BAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHAWANO |
Zip Code Of The Provider |
541662210 |
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 |
58 |
Number Of Services |
8106 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
276524.24 |
Total Medicare Allowed Amount |
91446.79 |
Total Medicare Payment Amount |
68143.15 |
Total Medicare Standardized Payment Amount |
70128.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
6644 |
Number Of Medicare Beneficiaries With Drug Services |
81 |
Total Drug Submitted ChargeAmount |
55122.24 |
Total Drug Medicare AllowedAmount |
28689.67 |
Total Drug Medicare PaymentAmount |
22994.23 |
Total Drug Medicare Standardized Payment Amount |
22994.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1462 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
221402 |
Total Medical Medicare Allowed Amount |
62757.12 |
Total Medical Medicare Payment Amount |
45148.92 |
Total Medical Medicare Standardized Payment Amount |
47134.51 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
264 |
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 |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9673 |