| National Provider Identifier [NPI]: | 1649268061 |
| Last Name Of The Provider | BEAUMONT |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15350 W NATIONAL AVE |
| Street Address 2 Of The Provider | SUITE 212 |
| City Of The Provider | NEW BERLIN |
| Zip Code Of The Provider | 531515158 |
| 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 | 76 |
| Number Of Services | 2200 |
| Number Of Medicare Beneficiaries | 133 |
| Total Submitted Charge Amount | 223278.64 |
| Total Medicare Allowed Amount | 90933.57 |
| Total Medicare Payment Amount | 67484.24 |
| Total Medicare Standardized Payment Amount | 70175.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 128 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 3172.64 |
| Total Drug Medicare AllowedAmount | 971.77 |
| Total Drug Medicare PaymentAmount | 883.2 |
| Total Drug Medicare Standardized Payment Amount | 883.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 2072 |
| Number Of Medicare Beneficiaries With Medical Services | 133 |
| Total Medical Submitted Charge Amount | 220106 |
| Total Medical Medicare Allowed Amount | 89961.8 |
| Total Medical Medicare Payment Amount | 66601.04 |
| Total Medical Medicare Standardized Payment Amount | 69291.9 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 54 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7635 |