National Provider Identifier [NPI]: |
1699117572 |
Last Name Of The Provider |
FLETCHER |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
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 |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
63 |
Number Of Medicare Beneficiaries |
36 |
Total Submitted Charge Amount |
5073.93 |
Total Medicare Allowed Amount |
4559.57 |
Total Medicare Payment Amount |
3708.05 |
Total Medicare Standardized Payment Amount |
3897.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
828.99 |
Total Drug Medicare AllowedAmount |
828.99 |
Total Drug Medicare PaymentAmount |
812.4 |
Total Drug Medicare Standardized Payment Amount |
812.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
51 |
Number Of Medicare Beneficiaries With Medical Services |
36 |
Total Medical Submitted Charge Amount |
4244.94 |
Total Medical Medicare Allowed Amount |
3730.58 |
Total Medical Medicare Payment Amount |
2895.65 |
Total Medical Medicare Standardized Payment Amount |
3084.82 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
17 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
36 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1171 |