National Provider Identifier [NPI]: |
1457538274 |
Last Name Of The Provider |
LEDESMA |
First Name Of The Provider |
WENDY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
945 N 12TH ST |
Street Address 2 Of The Provider |
AURORA SINAI MEDICAL CENTER |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532010342 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
620 |
Number Of Medicare Beneficiaries |
233 |
Total Submitted Charge Amount |
176345.87 |
Total Medicare Allowed Amount |
63230.31 |
Total Medicare Payment Amount |
49070.38 |
Total Medicare Standardized Payment Amount |
50655.92 |
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 |
27 |
Number Of Medical Services |
620 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
176345.87 |
Total Medical Medicare Allowed Amount |
63230.31 |
Total Medical Medicare Payment Amount |
49070.38 |
Total Medical Medicare Standardized Payment Amount |
50655.92 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
189 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4021 |