National Provider Identifier [NPI]: |
1265494421 |
Last Name Of The Provider |
SUTTER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8100 W 78TH ST STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINA |
Zip Code Of The Provider |
554392529 |
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 |
23 |
Number Of Services |
699 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
123495 |
Total Medicare Allowed Amount |
57316.19 |
Total Medicare Payment Amount |
44439.66 |
Total Medicare Standardized Payment Amount |
45370.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
82 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
5975 |
Total Drug Medicare AllowedAmount |
3352.17 |
Total Drug Medicare PaymentAmount |
3281.21 |
Total Drug Medicare Standardized Payment Amount |
3281.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
117520 |
Total Medical Medicare Allowed Amount |
53964.02 |
Total Medical Medicare Payment Amount |
41158.45 |
Total Medical Medicare Standardized Payment Amount |
42089.45 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
207 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0385 |