National Provider Identifier [NPI]: |
1962424333 |
Last Name Of The Provider |
JOSEPH |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3807 SPRING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RACINE |
Zip Code Of The Provider |
534051667 |
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 |
14 |
Number Of Services |
563 |
Number Of Medicare Beneficiaries |
493 |
Total Submitted Charge Amount |
95522 |
Total Medicare Allowed Amount |
41494.39 |
Total Medicare Payment Amount |
28062.31 |
Total Medicare Standardized Payment Amount |
29811.03 |
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 |
14 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
493 |
Total Medical Submitted Charge Amount |
95522 |
Total Medical Medicare Allowed Amount |
41494.39 |
Total Medical Medicare Payment Amount |
28062.31 |
Total Medical Medicare Standardized Payment Amount |
29811.03 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
168 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
347 |
Number Of Black or African American Beneficiaries |
100 |
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 |
335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.167 |