National Provider Identifier [NPI]: |
1093144123 |
Last Name Of The Provider |
NIENHUIS |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
957 BROOKHAVEN CT |
Street Address 2 Of The Provider |
BUILDING E, SUITE A & B |
City Of The Provider |
MUSKEGON |
Zip Code Of The Provider |
494423890 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
582 |
Number Of Medicare Beneficiaries |
243 |
Total Submitted Charge Amount |
60795.5 |
Total Medicare Allowed Amount |
37338.82 |
Total Medicare Payment Amount |
27399.45 |
Total Medicare Standardized Payment Amount |
34591.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1153.5 |
Total Drug Medicare AllowedAmount |
855.71 |
Total Drug Medicare PaymentAmount |
809.56 |
Total Drug Medicare Standardized Payment Amount |
809.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
546 |
Number Of Medicare Beneficiaries With Medical Services |
243 |
Total Medical Submitted Charge Amount |
59642 |
Total Medical Medicare Allowed Amount |
36483.11 |
Total Medical Medicare Payment Amount |
26589.89 |
Total Medical Medicare Standardized Payment Amount |
33781.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
217 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3899 |