Medicare Facts for Emily K. Clementson


National Provider Identifier [NPI]: 1609206432
Last Name Of The Provider CLEMENTSON
First Name Of The Provider EMILY
Middle Initial Of The Provider K
Credentials Of The Provider
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 649 OLD HIGHWAY 8 NW APT 321
Street Address 2 Of The Provider
City Of The Provider NEW BRIGHTON
Zip Code Of The Provider 551122868
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider CRNA
Medicare Participation Indicator Y
Number Of HCPCS 49
Number Of Services 114
Number Of Medicare Beneficiaries 113
Total Submitted Charge Amount 78860
Total Medicare Allowed Amount 17260.36
Total Medicare Payment Amount 13532.09
Total Medicare Standardized Payment Amount 14050.27
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 49
Number Of Medical Services 114
Number Of Medicare Beneficiaries With Medical Services 113
Total Medical Submitted Charge Amount 78860
Total Medical Medicare Allowed Amount 17260.36
Total Medical Medicare Payment Amount 13532.09
Total Medical Medicare Standardized Payment Amount 14050.27
Average Age Of Beneficiaries 70
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74 40
Number Of Beneficiaries Age 75 to 84 34
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 61
Number Of Male Beneficiaries 52
Number Of Non Hispanic White Beneficiaries 101
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 74
Number Of Beneficiaries With Medicare Medicaid Entitlement 39
Percent Of With Atrial Fibrillation 17
Percent Of With Alzheimers Disease or Dementia 15
Percent Of With Asthma 14
Percent Of With Cancer 22
Percent Of With Heart Failure 32
Percent Of With Chronic Kidney Disease 43
Percent Of With Chronic Obstructive Pulmonary Disease 20
Percent Of With Depression 27
Percent Of With Diabetes 40
Percent Of With Hyperlipidemia 70
Percent Of With Hypertension 75
Percent Of With Ischemic Heart Disease 50
Percent Of With Osteoporosis 10
Percent Of With Rheumatoid Arthritis Osteoarthritis 43
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 1.9709

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