National Provider Identifier [NPI]: |
1205801222 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
TODD |
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 |
640 JACKSON STREET |
Street Address 2 Of The Provider |
MAIL STOP 11101E |
City Of The Provider |
ST PAUL |
Zip Code Of The Provider |
551012502 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
203 |
Number Of Medicare Beneficiaries |
82 |
Total Submitted Charge Amount |
186617.8 |
Total Medicare Allowed Amount |
51328.57 |
Total Medicare Payment Amount |
38008.79 |
Total Medicare Standardized Payment Amount |
41739.23 |
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 |
64 |
Number Of Medical Services |
203 |
Number Of Medicare Beneficiaries With Medical Services |
82 |
Total Medical Submitted Charge Amount |
186617.8 |
Total Medical Medicare Allowed Amount |
51328.57 |
Total Medical Medicare Payment Amount |
38008.79 |
Total Medical Medicare Standardized Payment Amount |
41739.23 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
16 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
61 |
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 |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4271 |