National Provider Identifier [NPI]: |
1912981812 |
Last Name Of The Provider |
MILICH |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
112 JEFFERSON AVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432151702 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
849 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
68033 |
Total Medicare Allowed Amount |
34288.22 |
Total Medicare Payment Amount |
20726.06 |
Total Medicare Standardized Payment Amount |
26618.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
166 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
1935 |
Total Drug Medicare AllowedAmount |
1170.02 |
Total Drug Medicare PaymentAmount |
899.62 |
Total Drug Medicare Standardized Payment Amount |
899.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
683 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
66098 |
Total Medical Medicare Allowed Amount |
33118.2 |
Total Medical Medicare Payment Amount |
19826.44 |
Total Medical Medicare Standardized Payment Amount |
25718.84 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
38 |
Number Of Black or African American Beneficiaries |
155 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5462 |