National Provider Identifier [NPI]: |
1366441362 |
Last Name Of The Provider |
HENJUM |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13560 WAYZATA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINNETONKA |
Zip Code Of The Provider |
553051850 |
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 |
31 |
Number Of Services |
485 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
47687 |
Total Medicare Allowed Amount |
21458.84 |
Total Medicare Payment Amount |
14384.62 |
Total Medicare Standardized Payment Amount |
15035.17 |
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 |
31 |
Number Of Medical Services |
485 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
47687 |
Total Medical Medicare Allowed Amount |
21458.84 |
Total Medical Medicare Payment Amount |
14384.62 |
Total Medical Medicare Standardized Payment Amount |
15035.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
95 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
25 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9351 |