National Provider Identifier [NPI]: |
1235107335 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2651 WINDSOR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUN PRAIRIE |
Zip Code Of The Provider |
535909825 |
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 |
86 |
Number Of Services |
1552 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
134556 |
Total Medicare Allowed Amount |
45768.29 |
Total Medicare Payment Amount |
35633.38 |
Total Medicare Standardized Payment Amount |
36680.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
216 |
Number Of Medicare Beneficiaries With Drug Services |
190 |
Total Drug Submitted ChargeAmount |
8038 |
Total Drug Medicare AllowedAmount |
5638.02 |
Total Drug Medicare PaymentAmount |
5508.84 |
Total Drug Medicare Standardized Payment Amount |
5508.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
1336 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
126518 |
Total Medical Medicare Allowed Amount |
40130.27 |
Total Medical Medicare Payment Amount |
30124.54 |
Total Medical Medicare Standardized Payment Amount |
31172.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
268 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
44 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
17 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9027 |