National Provider Identifier [NPI]: |
1942204839 |
Last Name Of The Provider |
BAUMGAERTNER |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3111 GUNDERSEN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ONALASKA |
Zip Code Of The Provider |
546508447 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
2852 |
Number Of Medicare Beneficiaries |
509 |
Total Submitted Charge Amount |
331292.25 |
Total Medicare Allowed Amount |
107994.33 |
Total Medicare Payment Amount |
80619.78 |
Total Medicare Standardized Payment Amount |
84944.94 |
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 |
76 |
Number Of Medical Services |
2852 |
Number Of Medicare Beneficiaries With Medical Services |
509 |
Total Medical Submitted Charge Amount |
331292.25 |
Total Medical Medicare Allowed Amount |
107994.33 |
Total Medical Medicare Payment Amount |
80619.78 |
Total Medical Medicare Standardized Payment Amount |
84944.94 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
270 |
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 |
469 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9881 |