National Provider Identifier [NPI]: |
1306883160 |
Last Name Of The Provider |
DOCTER |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1313 FISH HATCHERY RD |
Street Address 2 Of The Provider |
DEAN MEDICAL CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151911 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
422 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
941962 |
Total Medicare Allowed Amount |
103111.47 |
Total Medicare Payment Amount |
78641.67 |
Total Medicare Standardized Payment Amount |
83368.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
192 |
Total Drug Medicare AllowedAmount |
53.05 |
Total Drug Medicare PaymentAmount |
36.06 |
Total Drug Medicare Standardized Payment Amount |
36.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
404 |
Number Of Medicare Beneficiaries With Medical Services |
223 |
Total Medical Submitted Charge Amount |
941770 |
Total Medical Medicare Allowed Amount |
103058.42 |
Total Medical Medicare Payment Amount |
78605.61 |
Total Medical Medicare Standardized Payment Amount |
83332.27 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
208 |
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 |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8576 |