National Provider Identifier [NPI]: |
1497730931 |
Last Name Of The Provider |
DUNCAN |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3850 PARK NICOLLET BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST LOUIS PARK |
Zip Code Of The Provider |
554162527 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
1092 |
Number Of Medicare Beneficiaries |
344 |
Total Submitted Charge Amount |
154360.01 |
Total Medicare Allowed Amount |
68114.47 |
Total Medicare Payment Amount |
51160.67 |
Total Medicare Standardized Payment Amount |
52382.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
1208 |
Total Drug Medicare AllowedAmount |
805.95 |
Total Drug Medicare PaymentAmount |
788.91 |
Total Drug Medicare Standardized Payment Amount |
788.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
1071 |
Number Of Medicare Beneficiaries With Medical Services |
344 |
Total Medical Submitted Charge Amount |
153152.01 |
Total Medical Medicare Allowed Amount |
67308.52 |
Total Medical Medicare Payment Amount |
50371.76 |
Total Medical Medicare Standardized Payment Amount |
51594.07 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7965 |