National Provider Identifier [NPI]: |
1801156385 |
Last Name Of The Provider |
BENSON |
First Name Of The Provider |
ELIZA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
AA-C |
Gender Of The Provider |
F |
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 |
537920001 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiologist Assistants |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
112 |
Number Of Medicare Beneficiaries |
111 |
Total Submitted Charge Amount |
179046 |
Total Medicare Allowed Amount |
19224.19 |
Total Medicare Payment Amount |
15071.75 |
Total Medicare Standardized Payment Amount |
15756.95 |
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 |
54 |
Number Of Medical Services |
112 |
Number Of Medicare Beneficiaries With Medical Services |
111 |
Total Medical Submitted Charge Amount |
179046 |
Total Medical Medicare Allowed Amount |
19224.19 |
Total Medical Medicare Payment Amount |
15071.75 |
Total Medical Medicare Standardized Payment Amount |
15756.95 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
52 |
Number Of Male Beneficiaries |
59 |
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 |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8774 |