National Provider Identifier [NPI]: |
1154541035 |
Last Name Of The Provider |
HEIKES |
First Name Of The Provider |
CHRISTIE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4010 W 65TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINA |
Zip Code Of The Provider |
554351706 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
812 |
Number Of Medicare Beneficiaries |
87 |
Total Submitted Charge Amount |
114562 |
Total Medicare Allowed Amount |
39519.42 |
Total Medicare Payment Amount |
29644.58 |
Total Medicare Standardized Payment Amount |
30681.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
519 |
Number Of Medicare Beneficiaries With Drug Services |
39 |
Total Drug Submitted ChargeAmount |
12687 |
Total Drug Medicare AllowedAmount |
7906.06 |
Total Drug Medicare PaymentAmount |
6048.5 |
Total Drug Medicare Standardized Payment Amount |
6048.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
293 |
Number Of Medicare Beneficiaries With Medical Services |
87 |
Total Medical Submitted Charge Amount |
101875 |
Total Medical Medicare Allowed Amount |
31613.36 |
Total Medical Medicare Payment Amount |
23596.08 |
Total Medical Medicare Standardized Payment Amount |
24632.94 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
67 |
Number Of Male Beneficiaries |
20 |
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 |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
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 |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
29 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8936 |