National Provider Identifier [NPI]: |
1780645309 |
Last Name Of The Provider |
BENDICKSON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 DELLWOOD ST S |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAMBRIDGE |
Zip Code Of The Provider |
550081920 |
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 |
22 |
Number Of Services |
522 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
52262 |
Total Medicare Allowed Amount |
19696.2 |
Total Medicare Payment Amount |
13987.99 |
Total Medicare Standardized Payment Amount |
17160.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
201 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
2142 |
Total Drug Medicare AllowedAmount |
826.29 |
Total Drug Medicare PaymentAmount |
636.09 |
Total Drug Medicare Standardized Payment Amount |
636.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
50120 |
Total Medical Medicare Allowed Amount |
18869.91 |
Total Medical Medicare Payment Amount |
13351.9 |
Total Medical Medicare Standardized Payment Amount |
16523.99 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
88 |
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1442 |