National Provider Identifier [NPI]: |
1053406660 |
Last Name Of The Provider |
TOWNE |
First Name Of The Provider |
KEITH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1216 RYANS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WORTHINGTON |
Zip Code Of The Provider |
561871722 |
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 |
70 |
Number Of Services |
916 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
26444.47 |
Total Medicare Allowed Amount |
25403.85 |
Total Medicare Payment Amount |
19438.25 |
Total Medicare Standardized Payment Amount |
19820.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
1386.91 |
Total Drug Medicare AllowedAmount |
1365.52 |
Total Drug Medicare PaymentAmount |
1332.15 |
Total Drug Medicare Standardized Payment Amount |
1332.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
864 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
25057.56 |
Total Medical Medicare Allowed Amount |
24038.33 |
Total Medical Medicare Payment Amount |
18106.1 |
Total Medical Medicare Standardized Payment Amount |
18488.29 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
35 |
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 |
58 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1459 |