National Provider Identifier [NPI]: |
1629054069 |
Last Name Of The Provider |
DANIELS |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
545 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
72932.67 |
Total Medicare Allowed Amount |
61928.2 |
Total Medicare Payment Amount |
48012.97 |
Total Medicare Standardized Payment Amount |
52635.39 |
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 |
43 |
Number Of Medical Services |
545 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
72932.67 |
Total Medical Medicare Allowed Amount |
61928.2 |
Total Medical Medicare Payment Amount |
48012.97 |
Total Medical Medicare Standardized Payment Amount |
52635.39 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
252 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.553 |