National Provider Identifier [NPI]: |
1912973496 |
Last Name Of The Provider |
BRODERICK |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
P |
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 |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
370 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
373347 |
Total Medicare Allowed Amount |
47180.38 |
Total Medicare Payment Amount |
36900.31 |
Total Medicare Standardized Payment Amount |
38463.22 |
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 |
74 |
Number Of Medical Services |
370 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
373347 |
Total Medical Medicare Allowed Amount |
47180.38 |
Total Medical Medicare Payment Amount |
36900.31 |
Total Medical Medicare Standardized Payment Amount |
38463.22 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
|
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 |
209 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.77 |