National Provider Identifier [NPI]: |
1043295587 |
Last Name Of The Provider |
DUKINFIELD |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6600 EXCELSIOR BLVD |
Street Address 2 Of The Provider |
SUITE 160 |
City Of The Provider |
ST LOUIS PARK |
Zip Code Of The Provider |
554264744 |
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 |
50 |
Number Of Services |
486 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
85335.3 |
Total Medicare Allowed Amount |
38515 |
Total Medicare Payment Amount |
28515.2 |
Total Medicare Standardized Payment Amount |
29642.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
1402 |
Total Drug Medicare AllowedAmount |
915.62 |
Total Drug Medicare PaymentAmount |
892.55 |
Total Drug Medicare Standardized Payment Amount |
892.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
451 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
83933.3 |
Total Medical Medicare Allowed Amount |
37599.38 |
Total Medical Medicare Payment Amount |
27622.65 |
Total Medical Medicare Standardized Payment Amount |
28750.3 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
138 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6124 |