National Provider Identifier [NPI]: |
1023050036 |
Last Name Of The Provider |
KRAEMER |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4040 COON RAPIDS BLVD NW |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554332522 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
987 |
Number Of Medicare Beneficiaries |
564 |
Total Submitted Charge Amount |
177988 |
Total Medicare Allowed Amount |
64849.79 |
Total Medicare Payment Amount |
48324.9 |
Total Medicare Standardized Payment Amount |
50149.43 |
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 |
50 |
Number Of Medical Services |
987 |
Number Of Medicare Beneficiaries With Medical Services |
564 |
Total Medical Submitted Charge Amount |
177988 |
Total Medical Medicare Allowed Amount |
64849.79 |
Total Medical Medicare Payment Amount |
48324.9 |
Total Medical Medicare Standardized Payment Amount |
50149.43 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
273 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
515 |
Number Of Black or African American Beneficiaries |
21 |
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 |
435 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8119 |