National Provider Identifier [NPI]: |
1609951631 |
Last Name Of The Provider |
SCHAEFER |
First Name Of The Provider |
DALE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 28TH ST S |
Street Address 2 Of The Provider |
SUITE 7 |
City Of The Provider |
GREAT FALLS |
Zip Code Of The Provider |
594055296 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
237 |
Total Submitted Charge Amount |
535035.01 |
Total Medicare Allowed Amount |
145727.74 |
Total Medicare Payment Amount |
112912.26 |
Total Medicare Standardized Payment Amount |
111235.97 |
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 |
44 |
Number Of Medical Services |
427 |
Number Of Medicare Beneficiaries With Medical Services |
237 |
Total Medical Submitted Charge Amount |
535035.01 |
Total Medical Medicare Allowed Amount |
145727.74 |
Total Medical Medicare Payment Amount |
112912.26 |
Total Medical Medicare Standardized Payment Amount |
111235.97 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
225 |
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 |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0689 |