National Provider Identifier [NPI]: |
1477651180 |
Last Name Of The Provider |
VARLEY |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
112 HELEN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAUK CITY |
Zip Code Of The Provider |
535831101 |
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 |
79 |
Number Of Services |
1310 |
Number Of Medicare Beneficiaries |
231 |
Total Submitted Charge Amount |
161894 |
Total Medicare Allowed Amount |
45651.37 |
Total Medicare Payment Amount |
31920.58 |
Total Medicare Standardized Payment Amount |
33626.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
1980 |
Total Drug Medicare AllowedAmount |
1506.58 |
Total Drug Medicare PaymentAmount |
1472.31 |
Total Drug Medicare Standardized Payment Amount |
1472.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
1256 |
Number Of Medicare Beneficiaries With Medical Services |
231 |
Total Medical Submitted Charge Amount |
159914 |
Total Medical Medicare Allowed Amount |
44144.79 |
Total Medical Medicare Payment Amount |
30448.27 |
Total Medical Medicare Standardized Payment Amount |
32154.47 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
106 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9916 |