National Provider Identifier [NPI]: |
1063603272 |
Last Name Of The Provider |
FIGUEROA |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6363 FRANCE AVE S |
Street Address 2 Of The Provider |
SUITE 525 |
City Of The Provider |
EDINA |
Zip Code Of The Provider |
554352129 |
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 |
82 |
Number Of Services |
830 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
71097.48 |
Total Medicare Allowed Amount |
30582.28 |
Total Medicare Payment Amount |
24560.18 |
Total Medicare Standardized Payment Amount |
25036.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1528.38 |
Total Drug Medicare AllowedAmount |
1103.48 |
Total Drug Medicare PaymentAmount |
1069.8 |
Total Drug Medicare Standardized Payment Amount |
1069.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
791 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
69569.1 |
Total Medical Medicare Allowed Amount |
29478.8 |
Total Medical Medicare Payment Amount |
23490.38 |
Total Medical Medicare Standardized Payment Amount |
23966.62 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
29 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1056 |