National Provider Identifier [NPI]: |
1639160583 |
Last Name Of The Provider |
PINKERTON |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 CENTRACARE CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT CLOUD |
Zip Code Of The Provider |
563035000 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
301 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
46453.25 |
Total Medicare Allowed Amount |
15178.53 |
Total Medicare Payment Amount |
13534.66 |
Total Medicare Standardized Payment Amount |
13870.21 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
251 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
33 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
0.9493 |