National Provider Identifier [NPI]: |
1891772067 |
Last Name Of The Provider |
FURDA |
First Name Of The Provider |
JAMES |
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 |
13367 ISLE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAXTER |
Zip Code Of The Provider |
564252221 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1893 |
Number Of Medicare Beneficiaries |
538 |
Total Submitted Charge Amount |
261483 |
Total Medicare Allowed Amount |
96063.09 |
Total Medicare Payment Amount |
72366.53 |
Total Medicare Standardized Payment Amount |
72925.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
790 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
1782 |
Total Drug Medicare AllowedAmount |
253.55 |
Total Drug Medicare PaymentAmount |
198.78 |
Total Drug Medicare Standardized Payment Amount |
198.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1103 |
Number Of Medicare Beneficiaries With Medical Services |
538 |
Total Medical Submitted Charge Amount |
259701 |
Total Medical Medicare Allowed Amount |
95809.54 |
Total Medical Medicare Payment Amount |
72167.75 |
Total Medical Medicare Standardized Payment Amount |
72726.37 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
97 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
276 |
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 |
460 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2748 |