National Provider Identifier [NPI]: |
1720320625 |
Last Name Of The Provider |
BULGRIN |
First Name Of The Provider |
ALLISON |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12380 PLAZA DR |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PARMA |
Zip Code Of The Provider |
441301043 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
772 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
82040 |
Total Medicare Allowed Amount |
49846.39 |
Total Medicare Payment Amount |
37689.22 |
Total Medicare Standardized Payment Amount |
45632.13 |
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 |
6 |
Number Of Medical Services |
772 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
82040 |
Total Medical Medicare Allowed Amount |
49846.39 |
Total Medical Medicare Payment Amount |
37689.22 |
Total Medical Medicare Standardized Payment Amount |
45632.13 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
29 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
72 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
58 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7929 |