National Provider Identifier [NPI]: |
1235156845 |
Last Name Of The Provider |
MAGURA |
First Name Of The Provider |
CONNIE |
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 |
1720 UNIVERSITY DR S |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARGO |
Zip Code Of The Provider |
581034940 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
253 |
Number Of Medicare Beneficiaries |
227 |
Total Submitted Charge Amount |
19653.5 |
Total Medicare Allowed Amount |
17439.38 |
Total Medicare Payment Amount |
10388.21 |
Total Medicare Standardized Payment Amount |
10722.4 |
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 |
15 |
Number Of Medical Services |
253 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
19653.5 |
Total Medical Medicare Allowed Amount |
17439.38 |
Total Medical Medicare Payment Amount |
10388.21 |
Total Medical Medicare Standardized Payment Amount |
10722.4 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
75 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0469 |