National Provider Identifier [NPI]: |
1457381212 |
Last Name Of The Provider |
LANTZ |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3000 32ND AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARGO |
Zip Code Of The Provider |
581036132 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
997 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
575469.25 |
Total Medicare Allowed Amount |
139715.14 |
Total Medicare Payment Amount |
106770.78 |
Total Medicare Standardized Payment Amount |
110911.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
255 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
800 |
Total Drug Medicare AllowedAmount |
477.87 |
Total Drug Medicare PaymentAmount |
366.73 |
Total Drug Medicare Standardized Payment Amount |
366.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
742 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
574669.25 |
Total Medical Medicare Allowed Amount |
139237.27 |
Total Medical Medicare Payment Amount |
106404.05 |
Total Medical Medicare Standardized Payment Amount |
110544.92 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
304 |
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 |
262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1961 |