National Provider Identifier [NPI]: |
1922254507 |
Last Name Of The Provider |
STESSMAN |
First Name Of The Provider |
CASEY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 PARK AVE # P7 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554151623 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
206 |
Number Of Medicare Beneficiaries |
125 |
Total Submitted Charge Amount |
46784 |
Total Medicare Allowed Amount |
19863.55 |
Total Medicare Payment Amount |
15359.14 |
Total Medicare Standardized Payment Amount |
18559.76 |
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 |
14 |
Number Of Medical Services |
206 |
Number Of Medicare Beneficiaries With Medical Services |
125 |
Total Medical Submitted Charge Amount |
46784 |
Total Medical Medicare Allowed Amount |
19863.55 |
Total Medical Medicare Payment Amount |
15359.14 |
Total Medical Medicare Standardized Payment Amount |
18559.76 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
46 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
68 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9538 |