National Provider Identifier [NPI]: |
1174589998 |
Last Name Of The Provider |
MARSHO |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1703 N TAYLOR DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHEBOYGAN |
Zip Code Of The Provider |
530811933 |
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 |
147 |
Number Of Services |
3744 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
356489.5 |
Total Medicare Allowed Amount |
128817.16 |
Total Medicare Payment Amount |
97452.64 |
Total Medicare Standardized Payment Amount |
100684.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
570 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
7698.5 |
Total Drug Medicare AllowedAmount |
2516.72 |
Total Drug Medicare PaymentAmount |
2343.69 |
Total Drug Medicare Standardized Payment Amount |
2343.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
136 |
Number Of Medical Services |
3174 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
348791 |
Total Medical Medicare Allowed Amount |
126300.44 |
Total Medical Medicare Payment Amount |
95108.95 |
Total Medical Medicare Standardized Payment Amount |
98340.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
447 |
Number Of Black or African American Beneficiaries |
0 |
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0955 |