National Provider Identifier [NPI]: |
1407883275 |
Last Name Of The Provider |
SHINKUNAS |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 E CAPITOL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
APPLETON |
Zip Code Of The Provider |
549118735 |
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 |
92 |
Number Of Services |
1420 |
Number Of Medicare Beneficiaries |
126 |
Total Submitted Charge Amount |
110946.65 |
Total Medicare Allowed Amount |
38738.98 |
Total Medicare Payment Amount |
30095.96 |
Total Medicare Standardized Payment Amount |
31008.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
1568 |
Total Drug Medicare AllowedAmount |
1001.71 |
Total Drug Medicare PaymentAmount |
975.33 |
Total Drug Medicare Standardized Payment Amount |
975.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
1373 |
Number Of Medicare Beneficiaries With Medical Services |
126 |
Total Medical Submitted Charge Amount |
109378.65 |
Total Medical Medicare Allowed Amount |
37737.27 |
Total Medical Medicare Payment Amount |
29120.63 |
Total Medical Medicare Standardized Payment Amount |
30033.57 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
113 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
29 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.022 |