National Provider Identifier [NPI]: |
1689808487 |
Last Name Of The Provider |
D'AGATA |
First Name Of The Provider |
CAITLIN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3209 DRYDEN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537043015 |
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 |
18 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
158 |
Total Submitted Charge Amount |
49599 |
Total Medicare Allowed Amount |
21477.89 |
Total Medicare Payment Amount |
16083.85 |
Total Medicare Standardized Payment Amount |
15410.46 |
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 |
18 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
158 |
Total Medical Submitted Charge Amount |
49599 |
Total Medical Medicare Allowed Amount |
21477.89 |
Total Medical Medicare Payment Amount |
16083.85 |
Total Medical Medicare Standardized Payment Amount |
15410.46 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3765 |