National Provider Identifier [NPI]: |
1821383993 |
Last Name Of The Provider |
SALONEN |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
250 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
29221.66 |
Total Medicare Allowed Amount |
25001.42 |
Total Medicare Payment Amount |
19386.91 |
Total Medicare Standardized Payment Amount |
21195.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
993.58 |
Total Drug Medicare AllowedAmount |
992.41 |
Total Drug Medicare PaymentAmount |
967.88 |
Total Drug Medicare Standardized Payment Amount |
967.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
221 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
28228.08 |
Total Medical Medicare Allowed Amount |
24009.01 |
Total Medical Medicare Payment Amount |
18419.03 |
Total Medical Medicare Standardized Payment Amount |
20227.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
70 |
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 |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0576 |