National Provider Identifier [NPI]: |
1396902219 |
Last Name Of The Provider |
ZURICH |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2920 SUPERIOR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHEBOYGAN |
Zip Code Of The Provider |
530811944 |
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 |
90 |
Number Of Services |
4405 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
534050.97 |
Total Medicare Allowed Amount |
138611.92 |
Total Medicare Payment Amount |
106245.83 |
Total Medicare Standardized Payment Amount |
110538.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
155 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
4000.5 |
Total Drug Medicare AllowedAmount |
1741.95 |
Total Drug Medicare PaymentAmount |
1643.29 |
Total Drug Medicare Standardized Payment Amount |
1643.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
83 |
Number Of Medical Services |
4250 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
530050.47 |
Total Medical Medicare Allowed Amount |
136869.97 |
Total Medical Medicare Payment Amount |
104602.54 |
Total Medical Medicare Standardized Payment Amount |
108894.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
82 |
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 |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0147 |