National Provider Identifier [NPI]: |
1679547103 |
Last Name Of The Provider |
STAN |
First Name Of The Provider |
MARIUS |
Middle Initial Of The Provider |
N |
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 |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
309 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
38757.19 |
Total Medicare Allowed Amount |
31613.62 |
Total Medicare Payment Amount |
23914.84 |
Total Medicare Standardized Payment Amount |
26082.43 |
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 |
16 |
Number Of Medical Services |
309 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
38757.19 |
Total Medical Medicare Allowed Amount |
31613.62 |
Total Medical Medicare Payment Amount |
23914.84 |
Total Medical Medicare Standardized Payment Amount |
26082.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
76 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6473 |