National Provider Identifier [NPI]: |
1487686747 |
Last Name Of The Provider |
GONZALES |
First Name Of The Provider |
JOYLYNN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
730 E 34TH ST |
Street Address 2 Of The Provider |
ESSENTIA HEALTH HIBBING CLINIC |
City Of The Provider |
HIBBING |
Zip Code Of The Provider |
557465109 |
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 |
174 |
Number Of Services |
7150 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
501103.5 |
Total Medicare Allowed Amount |
199557.83 |
Total Medicare Payment Amount |
151405.74 |
Total Medicare Standardized Payment Amount |
151693.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
42 |
Number Of Drug Services |
4916 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
256275.5 |
Total Drug Medicare AllowedAmount |
130718.15 |
Total Drug Medicare PaymentAmount |
101503.8 |
Total Drug Medicare Standardized Payment Amount |
101503.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
132 |
Number Of Medical Services |
2234 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
244828 |
Total Medical Medicare Allowed Amount |
68839.68 |
Total Medical Medicare Payment Amount |
49901.94 |
Total Medical Medicare Standardized Payment Amount |
50189.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
234 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1484 |