National Provider Identifier [NPI]: |
1881844397 |
Last Name Of The Provider |
WOLFF-BAKER |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3536 MENDOCINO AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954033634 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
566 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
108378 |
Total Medicare Allowed Amount |
45440.72 |
Total Medicare Payment Amount |
32529.19 |
Total Medicare Standardized Payment Amount |
38478.72 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
84 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
116 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
45 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.053 |