National Provider Identifier [NPI]: |
1780699074 |
Last Name Of The Provider |
ZAUN |
First Name Of The Provider |
HEATHER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15800 95TH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAPLE GROVE |
Zip Code Of The Provider |
553694400 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
852 |
Number Of Medicare Beneficiaries |
66 |
Total Submitted Charge Amount |
37819.23 |
Total Medicare Allowed Amount |
13542.03 |
Total Medicare Payment Amount |
9989.81 |
Total Medicare Standardized Payment Amount |
10886.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
728 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
11848 |
Total Drug Medicare AllowedAmount |
4530.51 |
Total Drug Medicare PaymentAmount |
3518.32 |
Total Drug Medicare Standardized Payment Amount |
3518.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
124 |
Number Of Medicare Beneficiaries With Medical Services |
66 |
Total Medical Submitted Charge Amount |
25971.23 |
Total Medical Medicare Allowed Amount |
9011.52 |
Total Medical Medicare Payment Amount |
6471.49 |
Total Medical Medicare Standardized Payment Amount |
7367.83 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
28 |
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 |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9081 |