National Provider Identifier [NPI]: |
1306925888 |
Last Name Of The Provider |
SOMERS |
First Name Of The Provider |
DONALD |
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 |
424 W STATE HIGHWAY 5 |
Street Address 2 Of The Provider |
|
City Of The Provider |
WACONIA |
Zip Code Of The Provider |
553871723 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
1646 |
Number Of Medicare Beneficiaries |
264 |
Total Submitted Charge Amount |
71208.21 |
Total Medicare Allowed Amount |
67501.67 |
Total Medicare Payment Amount |
51720.1 |
Total Medicare Standardized Payment Amount |
52708.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
65 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
2671.72 |
Total Drug Medicare AllowedAmount |
2299.1 |
Total Drug Medicare PaymentAmount |
2247.86 |
Total Drug Medicare Standardized Payment Amount |
2247.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
1581 |
Number Of Medicare Beneficiaries With Medical Services |
264 |
Total Medical Submitted Charge Amount |
68536.49 |
Total Medical Medicare Allowed Amount |
65202.57 |
Total Medical Medicare Payment Amount |
49472.24 |
Total Medical Medicare Standardized Payment Amount |
50461.04 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0937 |