National Provider Identifier [NPI]: |
1821065053 |
Last Name Of The Provider |
HAUG |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4050 COON RAPIDS BLVD |
Street Address 2 Of The Provider |
MERCY MEDICAL CENTER |
City Of The Provider |
COON RAPIDS |
Zip Code Of The Provider |
55433 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
723 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
249609.65 |
Total Medicare Allowed Amount |
54695.37 |
Total Medicare Payment Amount |
39713.76 |
Total Medicare Standardized Payment Amount |
41435.93 |
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 |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
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 |
65 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
328 |
Number Of Black or African American Beneficiaries |
16 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6317 |