National Provider Identifier [NPI]: |
1720049752 |
Last Name Of The Provider |
LOFGREN |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2251 CONNECTICUT AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
SARTELL |
Zip Code Of The Provider |
563772486 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
2005 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
165133 |
Total Medicare Allowed Amount |
60041.83 |
Total Medicare Payment Amount |
44817.58 |
Total Medicare Standardized Payment Amount |
46020.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
402 |
Number Of Medicare Beneficiaries With Drug Services |
74 |
Total Drug Submitted ChargeAmount |
2761 |
Total Drug Medicare AllowedAmount |
1435.81 |
Total Drug Medicare PaymentAmount |
1318.61 |
Total Drug Medicare Standardized Payment Amount |
1318.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
93 |
Number Of Medical Services |
1603 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
162372 |
Total Medical Medicare Allowed Amount |
58606.02 |
Total Medical Medicare Payment Amount |
43498.97 |
Total Medical Medicare Standardized Payment Amount |
44701.74 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
137 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1068 |