National Provider Identifier [NPI]: |
1518991199 |
Last Name Of The Provider |
NICHOLS |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
212 STURGEON EDDY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAUSAU |
Zip Code Of The Provider |
544036625 |
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 |
28 |
Number Of Services |
982 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
109715 |
Total Medicare Allowed Amount |
57962.18 |
Total Medicare Payment Amount |
38681.77 |
Total Medicare Standardized Payment Amount |
41462.94 |
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 |
28 |
Number Of Medical Services |
982 |
Number Of Medicare Beneficiaries With Medical Services |
362 |
Total Medical Submitted Charge Amount |
109715 |
Total Medical Medicare Allowed Amount |
57962.18 |
Total Medical Medicare Payment Amount |
38681.77 |
Total Medical Medicare Standardized Payment Amount |
41462.94 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
345 |
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 |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5124 |