National Provider Identifier [NPI]: |
1063488716 |
Last Name Of The Provider |
KRUGER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 WILLMAR AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLMAR |
Zip Code Of The Provider |
56201 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
128 |
Number Of Services |
1372 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
537397.38 |
Total Medicare Allowed Amount |
113597.65 |
Total Medicare Payment Amount |
88026.81 |
Total Medicare Standardized Payment Amount |
91574.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
781 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
1328.45 |
Total Drug Medicare AllowedAmount |
657.82 |
Total Drug Medicare PaymentAmount |
503.99 |
Total Drug Medicare Standardized Payment Amount |
503.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
124 |
Number Of Medical Services |
591 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
536068.93 |
Total Medical Medicare Allowed Amount |
112939.83 |
Total Medical Medicare Payment Amount |
87522.82 |
Total Medical Medicare Standardized Payment Amount |
91070.22 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
91 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5766 |