National Provider Identifier [NPI]: |
1033288584 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
106 2ND AVE NW |
Street Address 2 Of The Provider |
CENTRACARE CLINIC |
City Of The Provider |
ST JOSEPH |
Zip Code Of The Provider |
563744106 |
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 |
56 |
Number Of Services |
1899 |
Number Of Medicare Beneficiaries |
519 |
Total Submitted Charge Amount |
132224.25 |
Total Medicare Allowed Amount |
63093.59 |
Total Medicare Payment Amount |
51127.4 |
Total Medicare Standardized Payment Amount |
49663.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
986 |
Number Of Medicare Beneficiaries With Drug Services |
419 |
Total Drug Submitted ChargeAmount |
33993.25 |
Total Drug Medicare AllowedAmount |
19026.41 |
Total Drug Medicare PaymentAmount |
16609.61 |
Total Drug Medicare Standardized Payment Amount |
16609.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
913 |
Number Of Medicare Beneficiaries With Medical Services |
519 |
Total Medical Submitted Charge Amount |
98231 |
Total Medical Medicare Allowed Amount |
44067.18 |
Total Medical Medicare Payment Amount |
34517.79 |
Total Medical Medicare Standardized Payment Amount |
33054.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
502 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
407 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0304 |