National Provider Identifier [NPI]: |
1578538534 |
Last Name Of The Provider |
COLLETTI |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
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 |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
313 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
38855.39 |
Total Medicare Allowed Amount |
31721.94 |
Total Medicare Payment Amount |
23430.81 |
Total Medicare Standardized Payment Amount |
26333.86 |
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 |
17 |
Number Of Medical Services |
313 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
38855.39 |
Total Medical Medicare Allowed Amount |
31721.94 |
Total Medical Medicare Payment Amount |
23430.81 |
Total Medical Medicare Standardized Payment Amount |
26333.86 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
286 |
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7293 |