National Provider Identifier [NPI]: |
1124044383 |
Last Name Of The Provider |
DOWD |
First Name Of The Provider |
IVALEE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8202 EXCELSIOR DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537171906 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
1134 |
Number Of Medicare Beneficiaries |
295 |
Total Submitted Charge Amount |
141733 |
Total Medicare Allowed Amount |
24191.68 |
Total Medicare Payment Amount |
19450.66 |
Total Medicare Standardized Payment Amount |
22241.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
226 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
3583 |
Total Drug Medicare AllowedAmount |
1003.67 |
Total Drug Medicare PaymentAmount |
815.36 |
Total Drug Medicare Standardized Payment Amount |
815.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
908 |
Number Of Medicare Beneficiaries With Medical Services |
295 |
Total Medical Submitted Charge Amount |
138150 |
Total Medical Medicare Allowed Amount |
23188.01 |
Total Medical Medicare Payment Amount |
18635.3 |
Total Medical Medicare Standardized Payment Amount |
21426.19 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
217 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
277 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
33 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6959 |