National Provider Identifier [NPI]: |
1902892896 |
Last Name Of The Provider |
SELLON |
First Name Of The Provider |
JACOB |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1301 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
60138.8 |
Total Medicare Allowed Amount |
46946.72 |
Total Medicare Payment Amount |
35288.28 |
Total Medicare Standardized Payment Amount |
37879.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
807 |
Number Of Medicare Beneficiaries With Drug Services |
125 |
Total Drug Submitted ChargeAmount |
8872.59 |
Total Drug Medicare AllowedAmount |
8410.74 |
Total Drug Medicare PaymentAmount |
6320.92 |
Total Drug Medicare Standardized Payment Amount |
6320.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
494 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
51266.21 |
Total Medical Medicare Allowed Amount |
38535.98 |
Total Medical Medicare Payment Amount |
28967.36 |
Total Medical Medicare Standardized Payment Amount |
31558.71 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
233 |
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 |
225 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1603 |