National Provider Identifier [NPI]: |
1831175751 |
Last Name Of The Provider |
CRAGUN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 MARSH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANKATO |
Zip Code Of The Provider |
560014752 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
2325 |
Number Of Medicare Beneficiaries |
1010 |
Total Submitted Charge Amount |
806694.12 |
Total Medicare Allowed Amount |
147480.62 |
Total Medicare Payment Amount |
108994.41 |
Total Medicare Standardized Payment Amount |
112795.11 |
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 |
74 |
Number Of Medical Services |
2325 |
Number Of Medicare Beneficiaries With Medical Services |
1010 |
Total Medical Submitted Charge Amount |
806694.12 |
Total Medical Medicare Allowed Amount |
147480.62 |
Total Medical Medicare Payment Amount |
108994.41 |
Total Medical Medicare Standardized Payment Amount |
112795.11 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
347 |
Number Of Beneficiaries Age Greater 84 |
319 |
Number Of Female Beneficiaries |
473 |
Number Of Male Beneficiaries |
537 |
Number Of Non Hispanic White Beneficiaries |
988 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
882 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.571 |