National Provider Identifier [NPI]: |
1184707002 |
Last Name Of The Provider |
ROBINER |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
516 DELAWARE ST SE |
Street Address 2 Of The Provider |
PWB THIRD FLOOR, CLINIC 3A |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554550356 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
231 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
71502 |
Total Medicare Allowed Amount |
22303.33 |
Total Medicare Payment Amount |
15840.77 |
Total Medicare Standardized Payment Amount |
17197.55 |
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 |
5 |
Number Of Medical Services |
231 |
Number Of Medicare Beneficiaries With Medical Services |
54 |
Total Medical Submitted Charge Amount |
71502 |
Total Medical Medicare Allowed Amount |
22303.33 |
Total Medical Medicare Payment Amount |
15840.77 |
Total Medical Medicare Standardized Payment Amount |
17197.55 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
42 |
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 |
29 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
75 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.7769 |