National Provider Identifier [NPI]: |
1992711931 |
Last Name Of The Provider |
LINSE |
First Name Of The Provider |
JILL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8675 VALLEY CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WOODBURY |
Zip Code Of The Provider |
551252337 |
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 |
41 |
Number Of Services |
462 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
43084 |
Total Medicare Allowed Amount |
18384.28 |
Total Medicare Payment Amount |
12691.72 |
Total Medicare Standardized Payment Amount |
12972.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
528 |
Total Drug Medicare AllowedAmount |
232.65 |
Total Drug Medicare PaymentAmount |
184.57 |
Total Drug Medicare Standardized Payment Amount |
184.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
439 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
42556 |
Total Medical Medicare Allowed Amount |
18151.63 |
Total Medical Medicare Payment Amount |
12507.15 |
Total Medical Medicare Standardized Payment Amount |
12787.99 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
157 |
Number Of Black or African American Beneficiaries |
17 |
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 |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.058 |