National Provider Identifier [NPI]: |
1043249576 |
Last Name Of The Provider |
RICHIE |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5565 BLAINE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
INVER GROVE HEIGHTS |
Zip Code Of The Provider |
550761207 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
3336 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
235150 |
Total Medicare Allowed Amount |
100281.75 |
Total Medicare Payment Amount |
73996.52 |
Total Medicare Standardized Payment Amount |
75811.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
800 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
10156 |
Total Drug Medicare AllowedAmount |
4824.14 |
Total Drug Medicare PaymentAmount |
4616.48 |
Total Drug Medicare Standardized Payment Amount |
4616.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
2536 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
224994 |
Total Medical Medicare Allowed Amount |
95457.61 |
Total Medical Medicare Payment Amount |
69380.04 |
Total Medical Medicare Standardized Payment Amount |
71195.07 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
274 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0445 |