National Provider Identifier [NPI]: |
1205807310 |
Last Name Of The Provider |
PATACSIL |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1527 BROADWAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
563082537 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1360 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
145129 |
Total Medicare Allowed Amount |
58529.13 |
Total Medicare Payment Amount |
43929.59 |
Total Medicare Standardized Payment Amount |
44557.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
8675 |
Total Drug Medicare AllowedAmount |
2147.66 |
Total Drug Medicare PaymentAmount |
1736.25 |
Total Drug Medicare Standardized Payment Amount |
1736.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1310 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
136454 |
Total Medical Medicare Allowed Amount |
56381.47 |
Total Medical Medicare Payment Amount |
42193.34 |
Total Medical Medicare Standardized Payment Amount |
42821.43 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
76 |
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 |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2414 |