National Provider Identifier [NPI]: |
1477558104 |
Last Name Of The Provider |
BACHHUBER |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1032 S CESAR E CHAVEZ DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532042203 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
221 |
Number Of Medicare Beneficiaries |
56 |
Total Submitted Charge Amount |
11710 |
Total Medicare Allowed Amount |
3199.23 |
Total Medicare Payment Amount |
2645.36 |
Total Medicare Standardized Payment Amount |
2738.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
698 |
Total Drug Medicare AllowedAmount |
302.48 |
Total Drug Medicare PaymentAmount |
283.4 |
Total Drug Medicare Standardized Payment Amount |
283.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
206 |
Number Of Medicare Beneficiaries With Medical Services |
56 |
Total Medical Submitted Charge Amount |
11012 |
Total Medical Medicare Allowed Amount |
2896.75 |
Total Medical Medicare Payment Amount |
2361.96 |
Total Medical Medicare Standardized Payment Amount |
2454.84 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
28 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
11 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
30 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3712 |