National Provider Identifier [NPI]: |
1992723233 |
Last Name Of The Provider |
SCHLUETER |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1715 DOUSMAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREEN BAY |
Zip Code Of The Provider |
543033211 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
1876 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
778410.67 |
Total Medicare Allowed Amount |
161392.14 |
Total Medicare Payment Amount |
118658.21 |
Total Medicare Standardized Payment Amount |
124044.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
183 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
24503.25 |
Total Drug Medicare AllowedAmount |
20698.91 |
Total Drug Medicare PaymentAmount |
16075.86 |
Total Drug Medicare Standardized Payment Amount |
16075.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
81 |
Number Of Medical Services |
1693 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
753907.42 |
Total Medical Medicare Allowed Amount |
140693.23 |
Total Medical Medicare Payment Amount |
102582.35 |
Total Medical Medicare Standardized Payment Amount |
107968.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
309 |
Number Of Non Hispanic White Beneficiaries |
343 |
Number Of Black or African American Beneficiaries |
0 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
324 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1365 |