National Provider Identifier [NPI]: |
1760749097 |
Last Name Of The Provider |
BRUSKY |
First Name Of The Provider |
BRENDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1855 S KOELLER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OSHKOSH |
Zip Code Of The Provider |
549026186 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
208 |
Number Of Medicare Beneficiaries |
39 |
Total Submitted Charge Amount |
31145 |
Total Medicare Allowed Amount |
10019.9 |
Total Medicare Payment Amount |
7613.68 |
Total Medicare Standardized Payment Amount |
9174.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
55 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
1047 |
Total Drug Medicare AllowedAmount |
411.53 |
Total Drug Medicare PaymentAmount |
398.81 |
Total Drug Medicare Standardized Payment Amount |
398.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
153 |
Number Of Medicare Beneficiaries With Medical Services |
39 |
Total Medical Submitted Charge Amount |
30098 |
Total Medical Medicare Allowed Amount |
9608.37 |
Total Medical Medicare Payment Amount |
7214.87 |
Total Medical Medicare Standardized Payment Amount |
8776.05 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
24 |
Number Of Male Beneficiaries |
15 |
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 |
19 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
41 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.0883 |