National Provider Identifier [NPI]: |
1689823841 |
Last Name Of The Provider |
HUBER |
First Name Of The Provider |
JILL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
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 |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
35928.15 |
Total Medicare Allowed Amount |
30076.75 |
Total Medicare Payment Amount |
20561.28 |
Total Medicare Standardized Payment Amount |
22780.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
895.96 |
Total Drug Medicare AllowedAmount |
863.12 |
Total Drug Medicare PaymentAmount |
767.52 |
Total Drug Medicare Standardized Payment Amount |
767.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
392 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
35032.19 |
Total Medical Medicare Allowed Amount |
29213.63 |
Total Medical Medicare Payment Amount |
19793.76 |
Total Medical Medicare Standardized Payment Amount |
22013.4 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0248 |