National Provider Identifier [NPI]: |
1295720225 |
Last Name Of The Provider |
MCCABE |
First Name Of The Provider |
SCHELLI |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
316 S 3RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETER |
Zip Code Of The Provider |
560822023 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
568 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
34550.07 |
Total Medicare Allowed Amount |
32616.82 |
Total Medicare Payment Amount |
22062.35 |
Total Medicare Standardized Payment Amount |
22868.31 |
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 |
15 |
Number Of Medical Services |
568 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
34550.07 |
Total Medical Medicare Allowed Amount |
32616.82 |
Total Medical Medicare Payment Amount |
22062.35 |
Total Medical Medicare Standardized Payment Amount |
22868.31 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
75 |
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3085 |