National Provider Identifier [NPI]: |
1932186996 |
Last Name Of The Provider |
DILLON |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
J |
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 |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
731 |
Number Of Medicare Beneficiaries |
215 |
Total Submitted Charge Amount |
122270.53 |
Total Medicare Allowed Amount |
93345.07 |
Total Medicare Payment Amount |
68677.12 |
Total Medicare Standardized Payment Amount |
78094.68 |
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 |
21 |
Number Of Medical Services |
731 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
122270.53 |
Total Medical Medicare Allowed Amount |
93345.07 |
Total Medical Medicare Payment Amount |
68677.12 |
Total Medical Medicare Standardized Payment Amount |
78094.68 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
196 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
5.1979 |