National Provider Identifier [NPI]: |
1366469793 |
Last Name Of The Provider |
BORCHARDT |
First Name Of The Provider |
APRIL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3021 VOYAGER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREEN BAY |
Zip Code Of The Provider |
543118303 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
861 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
280123.79 |
Total Medicare Allowed Amount |
56740.16 |
Total Medicare Payment Amount |
41361.88 |
Total Medicare Standardized Payment Amount |
42189.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
199 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
6169 |
Total Drug Medicare AllowedAmount |
354.41 |
Total Drug Medicare PaymentAmount |
252.76 |
Total Drug Medicare Standardized Payment Amount |
252.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
662 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
273954.79 |
Total Medical Medicare Allowed Amount |
56385.75 |
Total Medical Medicare Payment Amount |
41109.12 |
Total Medical Medicare Standardized Payment Amount |
41936.45 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
62 |
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 |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8647 |