National Provider Identifier [NPI]: |
1851378509 |
Last Name Of The Provider |
WERDICK |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6500 EXCELSIOR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST LOUIS PARK |
Zip Code Of The Provider |
554264702 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
176 |
Number Of Services |
4630 |
Number Of Medicare Beneficiaries |
883 |
Total Submitted Charge Amount |
343228.7 |
Total Medicare Allowed Amount |
113992.92 |
Total Medicare Payment Amount |
84632.36 |
Total Medicare Standardized Payment Amount |
90117.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
3131 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
785.5 |
Total Drug Medicare AllowedAmount |
551.22 |
Total Drug Medicare PaymentAmount |
401.88 |
Total Drug Medicare Standardized Payment Amount |
401.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
174 |
Number Of Medical Services |
1499 |
Number Of Medicare Beneficiaries With Medical Services |
883 |
Total Medical Submitted Charge Amount |
342443.2 |
Total Medical Medicare Allowed Amount |
113441.7 |
Total Medical Medicare Payment Amount |
84230.48 |
Total Medical Medicare Standardized Payment Amount |
89715.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
196 |
Number Of Beneficiaries Age 65 to 74 |
263 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
489 |
Number Of Male Beneficiaries |
394 |
Number Of Non Hispanic White Beneficiaries |
780 |
Number Of Black or African American Beneficiaries |
52 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
659 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1134 |