National Provider Identifier [NPI]: |
1659548584 |
Last Name Of The Provider |
SNIDER |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1625 MAPLE LN |
Street Address 2 Of The Provider |
ESSENTIA HEALTH ASHLAND CLINIC |
City Of The Provider |
ASHLAND |
Zip Code Of The Provider |
548063768 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
1380 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
173975 |
Total Medicare Allowed Amount |
59498.35 |
Total Medicare Payment Amount |
44300.64 |
Total Medicare Standardized Payment Amount |
45924.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
132 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
3302.5 |
Total Drug Medicare AllowedAmount |
2156.91 |
Total Drug Medicare PaymentAmount |
2089.13 |
Total Drug Medicare Standardized Payment Amount |
2089.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
1248 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
170672.5 |
Total Medical Medicare Allowed Amount |
57341.44 |
Total Medical Medicare Payment Amount |
42211.51 |
Total Medical Medicare Standardized Payment Amount |
43835.15 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
212 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0176 |