National Provider Identifier [NPI]: |
1447480116 |
Last Name Of The Provider |
FRODL |
First Name Of The Provider |
KIMBERLY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
733 W CLAIREMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAU CLAIRE |
Zip Code Of The Provider |
547016101 |
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 |
28 |
Number Of Services |
489 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
50622.84 |
Total Medicare Allowed Amount |
24733.7 |
Total Medicare Payment Amount |
17880.14 |
Total Medicare Standardized Payment Amount |
19033.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
195 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
2177.84 |
Total Drug Medicare AllowedAmount |
1793.29 |
Total Drug Medicare PaymentAmount |
1741.59 |
Total Drug Medicare Standardized Payment Amount |
1741.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
294 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
48445 |
Total Medical Medicare Allowed Amount |
22940.41 |
Total Medical Medicare Payment Amount |
16138.55 |
Total Medical Medicare Standardized Payment Amount |
17292.31 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
63 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8935 |