National Provider Identifier [NPI]: |
1801161443 |
Last Name Of The Provider |
KOSKINIEMI |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
516 DELAWARE ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554550356 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
285 |
Number Of Medicare Beneficiaries |
132 |
Total Submitted Charge Amount |
28607.5 |
Total Medicare Allowed Amount |
10792.55 |
Total Medicare Payment Amount |
7434.01 |
Total Medicare Standardized Payment Amount |
9074.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
970.5 |
Total Drug Medicare AllowedAmount |
108.33 |
Total Drug Medicare PaymentAmount |
84.83 |
Total Drug Medicare Standardized Payment Amount |
84.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
240 |
Number Of Medicare Beneficiaries With Medical Services |
132 |
Total Medical Submitted Charge Amount |
27637 |
Total Medical Medicare Allowed Amount |
10684.22 |
Total Medical Medicare Payment Amount |
7349.18 |
Total Medical Medicare Standardized Payment Amount |
8990.13 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
116 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.948 |