National Provider Identifier [NPI]: |
1992780712 |
Last Name Of The Provider |
AHLERS |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 N STATE ST |
Street Address 2 Of The Provider |
WASECA MEDICAL CENTER - MAYO HEALTH SYSTEM |
City Of The Provider |
WASECA |
Zip Code Of The Provider |
560932811 |
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 |
10 |
Number Of Services |
424 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
102944 |
Total Medicare Allowed Amount |
45706.3 |
Total Medicare Payment Amount |
35699.64 |
Total Medicare Standardized Payment Amount |
36810.29 |
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 |
10 |
Number Of Medical Services |
424 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
102944 |
Total Medical Medicare Allowed Amount |
45706.3 |
Total Medical Medicare Payment Amount |
35699.64 |
Total Medical Medicare Standardized Payment Amount |
36810.29 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
171 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
33 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.9758 |