National Provider Identifier [NPI]: |
1659472280 |
Last Name Of The Provider |
WEST |
First Name Of The Provider |
MYLIN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9055 SPRINGBROOK DR NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
COON RAPIDS |
Zip Code Of The Provider |
554335841 |
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 |
39 |
Number Of Services |
730 |
Number Of Medicare Beneficiaries |
283 |
Total Submitted Charge Amount |
196473 |
Total Medicare Allowed Amount |
68226.57 |
Total Medicare Payment Amount |
51797.43 |
Total Medicare Standardized Payment Amount |
53243.19 |
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 |
74 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
92 |
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 |
224 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8282 |