National Provider Identifier [NPI]: |
1922232107 |
Last Name Of The Provider |
MEYER |
First Name Of The Provider |
DAIN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1021 BANDANA BLVD E STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT PAUL |
Zip Code Of The Provider |
551085109 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
303 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
69363.48 |
Total Medicare Allowed Amount |
22023.42 |
Total Medicare Payment Amount |
16497.66 |
Total Medicare Standardized Payment Amount |
17050.84 |
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 |
|
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 |
61 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
22 |
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 |
56 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1485 |