National Provider Identifier [NPI]: |
1316979933 |
Last Name Of The Provider |
FERNANDEZ-POKORNY |
First Name Of The Provider |
ANA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 E 3RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DULUTH |
Zip Code Of The Provider |
558051951 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1652 |
Number Of Medicare Beneficiaries |
602 |
Total Submitted Charge Amount |
91038 |
Total Medicare Allowed Amount |
48259.71 |
Total Medicare Payment Amount |
34567.57 |
Total Medicare Standardized Payment Amount |
35207.85 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
255 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
501 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
576 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
14 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
458 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1097 |