National Provider Identifier [NPI]: |
1457335614 |
Last Name Of The Provider |
LYON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 W BROWN DEER RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
BAYSIDE |
Zip Code Of The Provider |
532171618 |
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 |
189 |
Number Of Services |
1795 |
Number Of Medicare Beneficiaries |
1102 |
Total Submitted Charge Amount |
629282 |
Total Medicare Allowed Amount |
91354.36 |
Total Medicare Payment Amount |
70947.98 |
Total Medicare Standardized Payment Amount |
74174.05 |
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 |
189 |
Number Of Medical Services |
1795 |
Number Of Medicare Beneficiaries With Medical Services |
1102 |
Total Medical Submitted Charge Amount |
629282 |
Total Medical Medicare Allowed Amount |
91354.36 |
Total Medical Medicare Payment Amount |
70947.98 |
Total Medical Medicare Standardized Payment Amount |
74174.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
219 |
Number Of Beneficiaries Age 65 to 74 |
380 |
Number Of Beneficiaries Age 75 to 84 |
286 |
Number Of Beneficiaries Age Greater 84 |
217 |
Number Of Female Beneficiaries |
686 |
Number Of Male Beneficiaries |
416 |
Number Of Non Hispanic White Beneficiaries |
698 |
Number Of Black or African American Beneficiaries |
350 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
736 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
366 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9044 |