National Provider Identifier [NPI]: |
1518394246 |
Last Name Of The Provider |
HOFFMAN |
First Name Of The Provider |
BRIDGET |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2817 NEW PINERY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTAGE |
Zip Code Of The Provider |
539019240 |
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 |
27 |
Number Of Services |
363 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
44770 |
Total Medicare Allowed Amount |
17498.85 |
Total Medicare Payment Amount |
11618.65 |
Total Medicare Standardized Payment Amount |
14851.39 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
54 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2054 |