National Provider Identifier [NPI]: |
1083725014 |
Last Name Of The Provider |
KLEBIG |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
7193 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
378053.55 |
Total Medicare Allowed Amount |
344273.11 |
Total Medicare Payment Amount |
267867.9 |
Total Medicare Standardized Payment Amount |
276776.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
6784 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
311658.85 |
Total Drug Medicare AllowedAmount |
298854.59 |
Total Drug Medicare PaymentAmount |
233924.41 |
Total Drug Medicare Standardized Payment Amount |
233924.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
409 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
66394.7 |
Total Medical Medicare Allowed Amount |
45418.52 |
Total Medical Medicare Payment Amount |
33943.49 |
Total Medical Medicare Standardized Payment Amount |
42851.91 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
100 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7727 |