National Provider Identifier [NPI]: |
1821026188 |
Last Name Of The Provider |
EGGERT |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2105 E ENTERPRISE AVE |
Street Address 2 Of The Provider |
STE 112 |
City Of The Provider |
APPLETON |
Zip Code Of The Provider |
54913 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
2236 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
1232880 |
Total Medicare Allowed Amount |
158892.38 |
Total Medicare Payment Amount |
122578.27 |
Total Medicare Standardized Payment Amount |
128892.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1130 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
21855 |
Total Drug Medicare AllowedAmount |
11879.04 |
Total Drug Medicare PaymentAmount |
9214.61 |
Total Drug Medicare Standardized Payment Amount |
9214.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
1106 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
1211025 |
Total Medical Medicare Allowed Amount |
147013.34 |
Total Medical Medicare Payment Amount |
113363.66 |
Total Medical Medicare Standardized Payment Amount |
119678.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
102 |
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 |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0379 |