National Provider Identifier [NPI]: |
1588630644 |
Last Name Of The Provider |
HEGEMAN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
B |
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 |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
143 |
Number Of Services |
80295 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
2760175.5 |
Total Medicare Allowed Amount |
885713.67 |
Total Medicare Payment Amount |
691092.4 |
Total Medicare Standardized Payment Amount |
696640.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
55 |
Number Of Drug Services |
72324 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
2046104.5 |
Total Drug Medicare AllowedAmount |
712005.78 |
Total Drug Medicare PaymentAmount |
557468.91 |
Total Drug Medicare Standardized Payment Amount |
557468.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
7971 |
Number Of Medicare Beneficiaries With Medical Services |
435 |
Total Medical Submitted Charge Amount |
714071 |
Total Medical Medicare Allowed Amount |
173707.89 |
Total Medical Medicare Payment Amount |
133623.49 |
Total Medical Medicare Standardized Payment Amount |
139171.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
412 |
Number Of Black or African American Beneficiaries |
14 |
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 |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
51 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.597 |