National Provider Identifier [NPI]: |
1366626343 |
Last Name Of The Provider |
UFEARO |
First Name Of The Provider |
HILARY |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MBBS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 CENTRACARE CIRCLE, #1600 |
Street Address 2 Of The Provider |
CENTRACARE CLINIC HEALTH PLAZA SPECIALTIES/ONCOLOGY |
City Of The Provider |
ST CLOUD |
Zip Code Of The Provider |
563035000 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
890 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
174137 |
Total Medicare Allowed Amount |
68614.81 |
Total Medicare Payment Amount |
51204.54 |
Total Medicare Standardized Payment Amount |
52935.99 |
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 |
13 |
Number Of Medical Services |
890 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
174137 |
Total Medical Medicare Allowed Amount |
68614.81 |
Total Medical Medicare Payment Amount |
51204.54 |
Total Medical Medicare Standardized Payment Amount |
52935.99 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
251 |
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 |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0494 |