National Provider Identifier [NPI]: |
1982658357 |
Last Name Of The Provider |
BART |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 PARK AVE |
Street Address 2 Of The Provider |
P5 |
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 |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
746 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
73985 |
Total Medicare Allowed Amount |
35382.05 |
Total Medicare Payment Amount |
25748.13 |
Total Medicare Standardized Payment Amount |
26787.74 |
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 |
28 |
Number Of Medical Services |
746 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
73985 |
Total Medical Medicare Allowed Amount |
35382.05 |
Total Medical Medicare Payment Amount |
25748.13 |
Total Medical Medicare Standardized Payment Amount |
26787.74 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
232 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
279 |
Number Of Black or African American Beneficiaries |
119 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
258 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.6009 |