National Provider Identifier [NPI]: |
1073571089 |
Last Name Of The Provider |
NIELSEN |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 JEFFERSON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTHFIELD |
Zip Code Of The Provider |
550573081 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
246 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
136193.95 |
Total Medicare Allowed Amount |
39190.88 |
Total Medicare Payment Amount |
29823.1 |
Total Medicare Standardized Payment Amount |
31917.43 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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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 |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
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Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
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Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
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Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.1349 |