National Provider Identifier [NPI]: |
1497719678 |
Last Name Of The Provider |
WITTE |
First Name Of The Provider |
MELANIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
451 JUNCTION RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53717 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
697 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
137864 |
Total Medicare Allowed Amount |
34826.96 |
Total Medicare Payment Amount |
26656.1 |
Total Medicare Standardized Payment Amount |
32845.15 |
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 |
13 |
Number Of Medical Services |
697 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
137864 |
Total Medical Medicare Allowed Amount |
34826.96 |
Total Medical Medicare Payment Amount |
26656.1 |
Total Medical Medicare Standardized Payment Amount |
32845.15 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
174 |
Number Of Black or African American Beneficiaries |
19 |
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 |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.4598 |