National Provider Identifier [NPI]: |
1700066800 |
Last Name Of The Provider |
GEHL |
First Name Of The Provider |
JAMES |
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 |
500 W BROWN DEER RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
BAYSIDE |
Zip Code Of The Provider |
532171627 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
202 |
Number Of Services |
2373 |
Number Of Medicare Beneficiaries |
1351 |
Total Submitted Charge Amount |
822696 |
Total Medicare Allowed Amount |
119969.24 |
Total Medicare Payment Amount |
92966.26 |
Total Medicare Standardized Payment Amount |
97677.58 |
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 |
202 |
Number Of Medical Services |
2373 |
Number Of Medicare Beneficiaries With Medical Services |
1351 |
Total Medical Submitted Charge Amount |
822696 |
Total Medical Medicare Allowed Amount |
119969.24 |
Total Medical Medicare Payment Amount |
92966.26 |
Total Medical Medicare Standardized Payment Amount |
97677.58 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
189 |
Number Of Beneficiaries Age 65 to 74 |
441 |
Number Of Beneficiaries Age 75 to 84 |
454 |
Number Of Beneficiaries Age Greater 84 |
267 |
Number Of Female Beneficiaries |
775 |
Number Of Male Beneficiaries |
576 |
Number Of Non Hispanic White Beneficiaries |
1098 |
Number Of Black or African American Beneficiaries |
197 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1055 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
296 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8477 |