National Provider Identifier [NPI]: |
1932175767 |
Last Name Of The Provider |
WELSCH |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16105 S. LAGRANGE RD |
Street Address 2 Of The Provider |
SKINMD |
City Of The Provider |
ORLAND PARK |
Zip Code Of The Provider |
604675503 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
6741 |
Number Of Medicare Beneficiaries |
1709 |
Total Submitted Charge Amount |
1224618 |
Total Medicare Allowed Amount |
571140 |
Total Medicare Payment Amount |
427499.5 |
Total Medicare Standardized Payment Amount |
363191.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
110 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
330 |
Total Drug Medicare AllowedAmount |
195.73 |
Total Drug Medicare PaymentAmount |
145.11 |
Total Drug Medicare Standardized Payment Amount |
145.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
82 |
Number Of Medical Services |
6631 |
Number Of Medicare Beneficiaries With Medical Services |
1709 |
Total Medical Submitted Charge Amount |
1224288 |
Total Medical Medicare Allowed Amount |
570944.27 |
Total Medical Medicare Payment Amount |
427354.39 |
Total Medical Medicare Standardized Payment Amount |
363046.38 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
691 |
Number Of Beneficiaries Age 75 to 84 |
638 |
Number Of Beneficiaries Age Greater 84 |
323 |
Number Of Female Beneficiaries |
821 |
Number Of Male Beneficiaries |
888 |
Number Of Non Hispanic White Beneficiaries |
1615 |
Number Of Black or African American Beneficiaries |
44 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1660 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0986 |