National Provider Identifier [NPI]: |
1407833841 |
Last Name Of The Provider |
BARTLETT |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3850 PARK NICOLLET BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST LOUIS PARK |
Zip Code Of The Provider |
554162527 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1988 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
109741.14 |
Total Medicare Allowed Amount |
46536.04 |
Total Medicare Payment Amount |
35918.33 |
Total Medicare Standardized Payment Amount |
36869.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
87 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
6610 |
Total Drug Medicare AllowedAmount |
4274.19 |
Total Drug Medicare PaymentAmount |
4185.67 |
Total Drug Medicare Standardized Payment Amount |
4185.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1901 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
103131.14 |
Total Medical Medicare Allowed Amount |
42261.85 |
Total Medical Medicare Payment Amount |
31732.66 |
Total Medical Medicare Standardized Payment Amount |
32683.97 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
177 |
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.096 |