National Provider Identifier [NPI]: |
1730298910 |
Last Name Of The Provider |
SHAFFER |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 TOWN CENTRE DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
EAGAN |
Zip Code Of The Provider |
551231033 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
2793 |
Number Of Medicare Beneficiaries |
301 |
Total Submitted Charge Amount |
327020 |
Total Medicare Allowed Amount |
141323.82 |
Total Medicare Payment Amount |
104287.73 |
Total Medicare Standardized Payment Amount |
101723.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
7073 |
Total Drug Medicare AllowedAmount |
5708.3 |
Total Drug Medicare PaymentAmount |
4472.41 |
Total Drug Medicare Standardized Payment Amount |
4472.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
2736 |
Number Of Medicare Beneficiaries With Medical Services |
301 |
Total Medical Submitted Charge Amount |
319947 |
Total Medical Medicare Allowed Amount |
135615.52 |
Total Medical Medicare Payment Amount |
99815.32 |
Total Medical Medicare Standardized Payment Amount |
97250.79 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8912 |