National Provider Identifier [NPI]: |
1386606242 |
Last Name Of The Provider |
OLSON |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E 28TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554073723 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
82 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
121627.06 |
Total Medicare Allowed Amount |
18391.43 |
Total Medicare Payment Amount |
14418.91 |
Total Medicare Standardized Payment Amount |
15273.83 |
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 |
34 |
Number Of Medical Services |
82 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
121627.06 |
Total Medical Medicare Allowed Amount |
18391.43 |
Total Medical Medicare Payment Amount |
14418.91 |
Total Medical Medicare Standardized Payment Amount |
15273.83 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
35 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6427 |