| National Provider Identifier [NPI]: | 1609030584 |
| Last Name Of The Provider | GEIB |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1626 TUTTLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARABOO |
| Zip Code Of The Provider | 53913 |
| 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 | 52 |
| Number Of Services | 377 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 438641.34 |
| Total Medicare Allowed Amount | 20259.02 |
| Total Medicare Payment Amount | 15468.46 |
| Total Medicare Standardized Payment Amount | 17669.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 134 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 8213 |
| Total Drug Medicare AllowedAmount | 2478.82 |
| Total Drug Medicare PaymentAmount | 1939.24 |
| Total Drug Medicare Standardized Payment Amount | 1939.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 243 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 430428.34 |
| Total Medical Medicare Allowed Amount | 17780.2 |
| Total Medical Medicare Payment Amount | 13529.22 |
| Total Medical Medicare Standardized Payment Amount | 15730.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 57 |
| 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 | 106 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9817 |