National Provider Identifier [NPI]: |
1629031190 |
Last Name Of The Provider |
SCHMIDT |
First Name Of The Provider |
WADE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 SIXTH AVE N |
Street Address 2 Of The Provider |
CENTRACARE CLINIC |
City Of The Provider |
ST CLOUD |
Zip Code Of The Provider |
563032735 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
1394 |
Number Of Medicare Beneficiaries |
782 |
Total Submitted Charge Amount |
379898.44 |
Total Medicare Allowed Amount |
122077.38 |
Total Medicare Payment Amount |
92045.65 |
Total Medicare Standardized Payment Amount |
96825.52 |
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 |
73 |
Number Of Medical Services |
1394 |
Number Of Medicare Beneficiaries With Medical Services |
782 |
Total Medical Submitted Charge Amount |
379898.44 |
Total Medical Medicare Allowed Amount |
122077.38 |
Total Medical Medicare Payment Amount |
92045.65 |
Total Medical Medicare Standardized Payment Amount |
96825.52 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
299 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
372 |
Number Of Male Beneficiaries |
410 |
Number Of Non Hispanic White Beneficiaries |
754 |
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 |
614 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4361 |