National Provider Identifier [NPI]: |
1699888222 |
Last Name Of The Provider |
OLAFSDOTTIR |
First Name Of The Provider |
AGUSTA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
621 S NEW BALLAS RD STE 3016B |
Street Address 2 Of The Provider |
MERCY CLINIC ADULT HOSPITALIST |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631418267 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1040 |
Number Of Medicare Beneficiaries |
400 |
Total Submitted Charge Amount |
163406 |
Total Medicare Allowed Amount |
99396.6 |
Total Medicare Payment Amount |
77188.82 |
Total Medicare Standardized Payment Amount |
78568.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
1040 |
Number Of Medicare Beneficiaries With Medical Services |
400 |
Total Medical Submitted Charge Amount |
163406 |
Total Medical Medicare Allowed Amount |
99396.6 |
Total Medical Medicare Payment Amount |
77188.82 |
Total Medical Medicare Standardized Payment Amount |
78568.31 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
44 |
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 |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.373 |