National Provider Identifier [NPI]: |
1851323877 |
Last Name Of The Provider |
SPATZ |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 WESTWOOD DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAUSAU |
Zip Code Of The Provider |
544014152 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
765 |
Number Of Medicare Beneficiaries |
334 |
Total Submitted Charge Amount |
125194 |
Total Medicare Allowed Amount |
50555.8 |
Total Medicare Payment Amount |
39461.32 |
Total Medicare Standardized Payment Amount |
48116.27 |
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 |
15 |
Number Of Medical Services |
765 |
Number Of Medicare Beneficiaries With Medical Services |
334 |
Total Medical Submitted Charge Amount |
125194 |
Total Medical Medicare Allowed Amount |
50555.8 |
Total Medical Medicare Payment Amount |
39461.32 |
Total Medical Medicare Standardized Payment Amount |
48116.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
307 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.1077 |