National Provider Identifier [NPI]: |
1053328807 |
Last Name Of The Provider |
FOSTER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 SOUTH 70TH STREET |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685104293 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
732 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
75739 |
Total Medicare Allowed Amount |
31445.6 |
Total Medicare Payment Amount |
19976.44 |
Total Medicare Standardized Payment Amount |
27026.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
1476 |
Total Drug Medicare AllowedAmount |
712.66 |
Total Drug Medicare PaymentAmount |
654.16 |
Total Drug Medicare Standardized Payment Amount |
654.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
678 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
74263 |
Total Medical Medicare Allowed Amount |
30732.94 |
Total Medical Medicare Payment Amount |
19322.28 |
Total Medical Medicare Standardized Payment Amount |
26372.22 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
185 |
Number Of Black or African American Beneficiaries |
|
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9107 |