Medicare Facts for Debra R. Ellison, MSW


National Provider Identifier [NPI]: 1326077652
Last Name Of The Provider ELLISON
First Name Of The Provider DEBRA
Middle Initial Of The Provider R
Credentials Of The Provider MSW, LICSW
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 40 11TH ST
Street Address 2 Of The Provider
City Of The Provider CLOQUET
Zip Code Of The Provider 557201817
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider Licensed Clinical Social Worker
Medicare Participation Indicator Y
Number Of HCPCS 6
Number Of Services 381
Number Of Medicare Beneficiaries 63
Total Submitted Charge Amount 86203
Total Medicare Allowed Amount 27068.48
Total Medicare Payment Amount 19091.94
Total Medicare Standardized Payment Amount 19755.21
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 6
Number Of Medical Services 381
Number Of Medicare Beneficiaries With Medical Services 63
Total Medical Submitted Charge Amount 86203
Total Medical Medicare Allowed Amount 27068.48
Total Medical Medicare Payment Amount 19091.94
Total Medical Medicare Standardized Payment Amount 19755.21
Average Age Of Beneficiaries 51
Number Of Beneficiaries Age Less65
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 24
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 11
Number Of Beneficiaries With Medicare Medicaid Entitlement 52
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
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 75
Percent Of With Diabetes 32
Percent Of With Hyperlipidemia 27
Percent Of With Hypertension 30
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 19
Percent Of With Schizophrenia Other PsychoticDisorders 24
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 0.9679

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