| National Provider Identifier [NPI]: | 1770534208 |
| Last Name Of The Provider | AUGUSTSON |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 705 S UNIVERSITY AVE |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | BEAVER DAM |
| Zip Code Of The Provider | 539163081 |
| 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 | 71 |
| Number Of Services | 2649 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 298579.74 |
| Total Medicare Allowed Amount | 100977.41 |
| Total Medicare Payment Amount | 77113.98 |
| Total Medicare Standardized Payment Amount | 80031.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 114 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 3071 |
| Total Drug Medicare AllowedAmount | 1711.18 |
| Total Drug Medicare PaymentAmount | 1639.36 |
| Total Drug Medicare Standardized Payment Amount | 1639.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 2535 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 295508.74 |
| Total Medical Medicare Allowed Amount | 99266.23 |
| Total Medical Medicare Payment Amount | 75474.62 |
| Total Medical Medicare Standardized Payment Amount | 78392.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 134 |
| 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 | 259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1325 |