| National Provider Identifier [NPI]: | 1447514773 |
| Last Name Of The Provider | ACKER |
| First Name Of The Provider | CARLEEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 752 N HIGH POINT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537172236 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 409 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 65797 |
| Total Medicare Allowed Amount | 16821.62 |
| Total Medicare Payment Amount | 11868.78 |
| Total Medicare Standardized Payment Amount | 14556.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 762 |
| Total Drug Medicare AllowedAmount | 528.8 |
| Total Drug Medicare PaymentAmount | 473.6 |
| Total Drug Medicare Standardized Payment Amount | 473.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 375 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 65035 |
| Total Medical Medicare Allowed Amount | 16292.82 |
| Total Medical Medicare Payment Amount | 11395.18 |
| Total Medical Medicare Standardized Payment Amount | 14082.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 48 |
| 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 | 133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8838 |