National Provider Identifier [NPI]: |
1285990226 |
Last Name Of The Provider |
CRUSER |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
RN, CNS |
Gender Of The Provider |
F |
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 |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
349 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
80484.75 |
Total Medicare Allowed Amount |
28070.95 |
Total Medicare Payment Amount |
20338.61 |
Total Medicare Standardized Payment Amount |
25006.47 |
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 |
10 |
Number Of Medical Services |
349 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
80484.75 |
Total Medical Medicare Allowed Amount |
28070.95 |
Total Medical Medicare Payment Amount |
20338.61 |
Total Medical Medicare Standardized Payment Amount |
25006.47 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
109 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
64 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8527 |