| National Provider Identifier [NPI]: | 1295840775 |
| Last Name Of The Provider | MARQUARDT |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 806 SECOND STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHETEK |
| Zip Code Of The Provider | 54728 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 5355 |
| Number Of Medicare Beneficiaries | 331 |
| Total Submitted Charge Amount | 262835.4 |
| Total Medicare Allowed Amount | 110058.12 |
| Total Medicare Payment Amount | 79525.36 |
| Total Medicare Standardized Payment Amount | 82809.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3729 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 55392.87 |
| Total Drug Medicare AllowedAmount | 28955.69 |
| Total Drug Medicare PaymentAmount | 23091.81 |
| Total Drug Medicare Standardized Payment Amount | 23091.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1626 |
| Number Of Medicare Beneficiaries With Medical Services | 331 |
| Total Medical Submitted Charge Amount | 207442.53 |
| Total Medical Medicare Allowed Amount | 81102.43 |
| Total Medical Medicare Payment Amount | 56433.55 |
| Total Medical Medicare Standardized Payment Amount | 59717.56 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 319 |
| 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 | 201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0831 |