National Provider Identifier [NPI]: |
1346479805 |
Last Name Of The Provider |
JUNNILA |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
407 E 3RD ST |
Street Address 2 Of The Provider |
ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER |
City Of The Provider |
DULUTH |
Zip Code Of The Provider |
558051950 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
366 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
159877 |
Total Medicare Allowed Amount |
45120.81 |
Total Medicare Payment Amount |
34507.35 |
Total Medicare Standardized Payment Amount |
36020.89 |
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 |
24 |
Number Of Medical Services |
366 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
159877 |
Total Medical Medicare Allowed Amount |
45120.81 |
Total Medical Medicare Payment Amount |
34507.35 |
Total Medical Medicare Standardized Payment Amount |
36020.89 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
276 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
24 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
158 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7353 |