National Provider Identifier [NPI]: |
1851531628 |
Last Name Of The Provider |
SCANDRICK |
First Name Of The Provider |
DESHAY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2912 SPRINGBORO RD |
Street Address 2 Of The Provider |
SUTIE 201 |
City Of The Provider |
MORAINE |
Zip Code Of The Provider |
454391674 |
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 |
3 |
Number Of Services |
928 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
88486 |
Total Medicare Allowed Amount |
69498.94 |
Total Medicare Payment Amount |
53626.26 |
Total Medicare Standardized Payment Amount |
66076.11 |
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 |
3 |
Number Of Medical Services |
928 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
88486 |
Total Medical Medicare Allowed Amount |
69498.94 |
Total Medical Medicare Payment Amount |
53626.26 |
Total Medical Medicare Standardized Payment Amount |
66076.11 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
117 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
58 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.6487 |