National Provider Identifier [NPI]: |
1821084450 |
Last Name Of The Provider |
MAKEEVER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3916 N INTERTECH CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
APPLETON |
Zip Code Of The Provider |
54913 |
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 |
124 |
Number Of Services |
1781 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
176550 |
Total Medicare Allowed Amount |
43770.72 |
Total Medicare Payment Amount |
32350.97 |
Total Medicare Standardized Payment Amount |
33717.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
442 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2559 |
Total Drug Medicare AllowedAmount |
1247.51 |
Total Drug Medicare PaymentAmount |
1172.01 |
Total Drug Medicare Standardized Payment Amount |
1172.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
117 |
Number Of Medical Services |
1339 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
173991 |
Total Medical Medicare Allowed Amount |
42523.21 |
Total Medical Medicare Payment Amount |
31178.96 |
Total Medical Medicare Standardized Payment Amount |
32545.9 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
64 |
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 |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
17 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7922 |