National Provider Identifier [NPI]: |
1407821754 |
Last Name Of The Provider |
MAAG |
First Name Of The Provider |
TERRENCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 PHALEN BLVD |
Street Address 2 Of The Provider |
MC 41103F |
City Of The Provider |
SAINT PAUL |
Zip Code Of The Provider |
551305302 |
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 |
38 |
Number Of Services |
408 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
74543 |
Total Medicare Allowed Amount |
28001.99 |
Total Medicare Payment Amount |
18767.4 |
Total Medicare Standardized Payment Amount |
19371.85 |
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 |
71 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
22 |
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 |
60 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0222 |