National Provider Identifier [NPI]: |
1346204989 |
Last Name Of The Provider |
DAILEY |
First Name Of The Provider |
SETH |
Middle Initial Of The Provider |
H |
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 |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
1102 |
Number Of Medicare Beneficiaries |
422 |
Total Submitted Charge Amount |
1028418 |
Total Medicare Allowed Amount |
154084.04 |
Total Medicare Payment Amount |
115602.53 |
Total Medicare Standardized Payment Amount |
119258.12 |
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 |
82 |
Number Of Medical Services |
1102 |
Number Of Medicare Beneficiaries With Medical Services |
422 |
Total Medical Submitted Charge Amount |
1028418 |
Total Medical Medicare Allowed Amount |
154084.04 |
Total Medical Medicare Payment Amount |
115602.53 |
Total Medical Medicare Standardized Payment Amount |
119258.12 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
391 |
Number Of Black or African American Beneficiaries |
16 |
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 |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3656 |