National Provider Identifier [NPI]: |
1306904057 |
Last Name Of The Provider |
SWANSON |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1024 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICE LAKE |
Zip Code Of The Provider |
548680028 |
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 |
149 |
Number Of Services |
3307 |
Number Of Medicare Beneficiaries |
1793 |
Total Submitted Charge Amount |
605747.62 |
Total Medicare Allowed Amount |
98925.61 |
Total Medicare Payment Amount |
80414.76 |
Total Medicare Standardized Payment Amount |
83924.08 |
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 |
149 |
Number Of Medical Services |
3307 |
Number Of Medicare Beneficiaries With Medical Services |
1793 |
Total Medical Submitted Charge Amount |
605747.62 |
Total Medical Medicare Allowed Amount |
98925.61 |
Total Medical Medicare Payment Amount |
80414.76 |
Total Medical Medicare Standardized Payment Amount |
83924.08 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
295 |
Number Of Beneficiaries Age 65 to 74 |
755 |
Number Of Beneficiaries Age 75 to 84 |
496 |
Number Of Beneficiaries Age Greater 84 |
247 |
Number Of Female Beneficiaries |
1154 |
Number Of Male Beneficiaries |
639 |
Number Of Non Hispanic White Beneficiaries |
1670 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
87 |
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
525 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1681 |