National Provider Identifier [NPI]: |
1710146097 |
Last Name Of The Provider |
PASZKIEWICZ |
First Name Of The Provider |
EWA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
835 PARKSIDE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIPON |
Zip Code Of The Provider |
549718505 |
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 |
24 |
Number Of Services |
661 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
63983 |
Total Medicare Allowed Amount |
27674.72 |
Total Medicare Payment Amount |
20844.69 |
Total Medicare Standardized Payment Amount |
21634.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
332 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1309 |
Total Drug Medicare AllowedAmount |
1036.21 |
Total Drug Medicare PaymentAmount |
997.87 |
Total Drug Medicare Standardized Payment Amount |
997.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
329 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
62674 |
Total Medical Medicare Allowed Amount |
26638.51 |
Total Medical Medicare Payment Amount |
19846.82 |
Total Medical Medicare Standardized Payment Amount |
20636.79 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
28 |
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 |
87 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0248 |