National Provider Identifier [NPI]: |
1629256581 |
Last Name Of The Provider |
STAGGS |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 SOUTH COLUMBIA ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND FORKS |
Zip Code Of The Provider |
582066002 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
423 |
Number Of Medicare Beneficiaries |
330 |
Total Submitted Charge Amount |
347489.25 |
Total Medicare Allowed Amount |
48284.2 |
Total Medicare Payment Amount |
36008.25 |
Total Medicare Standardized Payment Amount |
39792.45 |
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 |
79 |
Number Of Medical Services |
423 |
Number Of Medicare Beneficiaries With Medical Services |
330 |
Total Medical Submitted Charge Amount |
347489.25 |
Total Medical Medicare Allowed Amount |
48284.2 |
Total Medical Medicare Payment Amount |
36008.25 |
Total Medical Medicare Standardized Payment Amount |
39792.45 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
299 |
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 |
240 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5847 |