| National Provider Identifier [NPI]: | 1134125842 |
| Last Name Of The Provider | PUCCINELLI |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7545 N PORT WASHINGTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 532173422 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 2015 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 630891 |
| Total Medicare Allowed Amount | 189668.01 |
| Total Medicare Payment Amount | 143974.2 |
| Total Medicare Standardized Payment Amount | 148010.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 633 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 108131 |
| Total Drug Medicare AllowedAmount | 65609.97 |
| Total Drug Medicare PaymentAmount | 50963.39 |
| Total Drug Medicare Standardized Payment Amount | 50963.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 1382 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 522760 |
| Total Medical Medicare Allowed Amount | 124058.04 |
| Total Medical Medicare Payment Amount | 93010.81 |
| Total Medical Medicare Standardized Payment Amount | 97046.87 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 67 |
| Number Of Non Hispanic White Beneficiaries | 196 |
| 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 | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.241 |