National Provider Identifier [NPI]: |
1841505336 |
Last Name Of The Provider |
HOLGUIN |
First Name Of The Provider |
PABLO |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2901 W KINNICKINNIC RIVER PKWY |
Street Address 2 Of The Provider |
315 |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
53215 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1277 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
392631 |
Total Medicare Allowed Amount |
122169 |
Total Medicare Payment Amount |
91887.94 |
Total Medicare Standardized Payment Amount |
97578.06 |
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 |
16 |
Number Of Medical Services |
1277 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
392631 |
Total Medical Medicare Allowed Amount |
122169 |
Total Medical Medicare Payment Amount |
91887.94 |
Total Medical Medicare Standardized Payment Amount |
97578.06 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
303 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
264 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.6843 |