National Provider Identifier [NPI]: |
1083711659 |
Last Name Of The Provider |
SHADMAN |
First Name Of The Provider |
SHAWYON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 S PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151830 |
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 |
195 |
Number Of Services |
11302 |
Number Of Medicare Beneficiaries |
2858 |
Total Submitted Charge Amount |
1650488.56 |
Total Medicare Allowed Amount |
186907.57 |
Total Medicare Payment Amount |
141908.88 |
Total Medicare Standardized Payment Amount |
148663.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
7078 |
Number Of Medicare Beneficiaries With Drug Services |
96 |
Total Drug Submitted ChargeAmount |
8988.5 |
Total Drug Medicare AllowedAmount |
3371.82 |
Total Drug Medicare PaymentAmount |
2436.04 |
Total Drug Medicare Standardized Payment Amount |
2436.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
185 |
Number Of Medical Services |
4224 |
Number Of Medicare Beneficiaries With Medical Services |
2856 |
Total Medical Submitted Charge Amount |
1641500.06 |
Total Medical Medicare Allowed Amount |
183535.75 |
Total Medical Medicare Payment Amount |
139472.84 |
Total Medical Medicare Standardized Payment Amount |
146227.88 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
459 |
Number Of Beneficiaries Age 65 to 74 |
1094 |
Number Of Beneficiaries Age 75 to 84 |
797 |
Number Of Beneficiaries Age Greater 84 |
508 |
Number Of Female Beneficiaries |
1780 |
Number Of Male Beneficiaries |
1078 |
Number Of Non Hispanic White Beneficiaries |
2718 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
39 |
Number Of Beneficiaries With Medicare Only Entitlement |
2228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
630 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2889 |