National Provider Identifier [NPI]: |
1710948187 |
Last Name Of The Provider |
GRAU |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2880 UNIVERSITY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53705 |
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 |
7 |
Number Of Services |
869 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
173228 |
Total Medicare Allowed Amount |
59427.27 |
Total Medicare Payment Amount |
43809.68 |
Total Medicare Standardized Payment Amount |
53829.77 |
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 |
7 |
Number Of Medical Services |
869 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
173228 |
Total Medical Medicare Allowed Amount |
59427.27 |
Total Medical Medicare Payment Amount |
43809.68 |
Total Medical Medicare Standardized Payment Amount |
53829.77 |
Average Age Of Beneficiaries |
86 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
58 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
55 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
34 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8286 |