| National Provider Identifier [NPI]: | 1861469470 |
| Last Name Of The Provider | HAGEN |
| First Name Of The Provider | TAMARA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 S PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 53715 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3490 |
| Number Of Medicare Beneficiaries | 838 |
| Total Submitted Charge Amount | 1186327 |
| Total Medicare Allowed Amount | 192636.57 |
| Total Medicare Payment Amount | 145817.3 |
| Total Medicare Standardized Payment Amount | 151375.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 319 |
| Number Of Medicare Beneficiaries With Drug Services | 108 |
| Total Drug Submitted ChargeAmount | 31512 |
| Total Drug Medicare AllowedAmount | 16148.31 |
| Total Drug Medicare PaymentAmount | 12702.57 |
| Total Drug Medicare Standardized Payment Amount | 12702.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3171 |
| Number Of Medicare Beneficiaries With Medical Services | 838 |
| Total Medical Submitted Charge Amount | 1154815 |
| Total Medical Medicare Allowed Amount | 176488.26 |
| Total Medical Medicare Payment Amount | 133114.73 |
| Total Medical Medicare Standardized Payment Amount | 138672.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 376 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 424 |
| Number Of Non Hispanic White Beneficiaries | 775 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2479 |