National Provider Identifier [NPI]: |
1912976168 |
Last Name Of The Provider |
SCHUNEMAN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9055 SPRINGBROOK DR NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
COON RAPIDS |
Zip Code Of The Provider |
554335841 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
371 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
31596 |
Total Medicare Allowed Amount |
11648.58 |
Total Medicare Payment Amount |
8172.18 |
Total Medicare Standardized Payment Amount |
9901.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
638 |
Total Drug Medicare AllowedAmount |
384.15 |
Total Drug Medicare PaymentAmount |
249.85 |
Total Drug Medicare Standardized Payment Amount |
249.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
355 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
30958 |
Total Medical Medicare Allowed Amount |
11264.43 |
Total Medical Medicare Payment Amount |
7922.33 |
Total Medical Medicare Standardized Payment Amount |
9651.97 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
42 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
43 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
22 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9372 |