National Provider Identifier [NPI]: |
1205992237 |
Last Name Of The Provider |
LINDSEY |
First Name Of The Provider |
MICHELE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
145 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FOND DU LAC |
Zip Code Of The Provider |
549353423 |
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 |
39 |
Number Of Services |
521 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
87159 |
Total Medicare Allowed Amount |
30114.72 |
Total Medicare Payment Amount |
19015.23 |
Total Medicare Standardized Payment Amount |
20769.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
1106 |
Total Drug Medicare AllowedAmount |
416.6 |
Total Drug Medicare PaymentAmount |
298.51 |
Total Drug Medicare Standardized Payment Amount |
298.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
483 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
86053 |
Total Medical Medicare Allowed Amount |
29698.12 |
Total Medical Medicare Payment Amount |
18716.72 |
Total Medical Medicare Standardized Payment Amount |
20471.08 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
313 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9798 |