National Provider Identifier [NPI]: |
1912085416 |
Last Name Of The Provider |
BUCHANAN |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
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 |
#165 |
City Of The Provider |
NEW BERLIN |
Zip Code Of The Provider |
531514497 |
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 |
73 |
Number Of Services |
1388 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
346417.95 |
Total Medicare Allowed Amount |
110937.57 |
Total Medicare Payment Amount |
82663.09 |
Total Medicare Standardized Payment Amount |
88937.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
198 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
11703.95 |
Total Drug Medicare AllowedAmount |
4921.21 |
Total Drug Medicare PaymentAmount |
4295.46 |
Total Drug Medicare Standardized Payment Amount |
4295.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
1190 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
334714 |
Total Medical Medicare Allowed Amount |
106016.36 |
Total Medical Medicare Payment Amount |
78367.63 |
Total Medical Medicare Standardized Payment Amount |
84642.46 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
149 |
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0511 |