National Provider Identifier [NPI]: |
1962495978 |
Last Name Of The Provider |
BASILE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14555 W NATIONAL AVE |
Street Address 2 Of The Provider |
SUITE 170 |
City Of The Provider |
NEW BERLIN |
Zip Code Of The Provider |
531514494 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2974 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
618939.42 |
Total Medicare Allowed Amount |
196913.49 |
Total Medicare Payment Amount |
145089.81 |
Total Medicare Standardized Payment Amount |
152459.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
153 |
Number Of Medicare Beneficiaries With Drug Services |
124 |
Total Drug Submitted ChargeAmount |
6679.42 |
Total Drug Medicare AllowedAmount |
3597.41 |
Total Drug Medicare PaymentAmount |
3443.71 |
Total Drug Medicare Standardized Payment Amount |
3443.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
2821 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
612260 |
Total Medical Medicare Allowed Amount |
193316.08 |
Total Medical Medicare Payment Amount |
141646.1 |
Total Medical Medicare Standardized Payment Amount |
149015.92 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
283 |
Number Of Non Hispanic White Beneficiaries |
558 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
546 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1276 |