National Provider Identifier [NPI]: |
1003883224 |
Last Name Of The Provider |
HERRON |
First Name Of The Provider |
DIANE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
BS MS BSN MSN CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25200 CENTER RIDGE ROAD |
Street Address 2 Of The Provider |
SUITE 1100 |
City Of The Provider |
WESTLAKE |
Zip Code Of The Provider |
44145 |
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 |
7 |
Number Of Services |
274 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
81031 |
Total Medicare Allowed Amount |
15280.68 |
Total Medicare Payment Amount |
11883.28 |
Total Medicare Standardized Payment Amount |
14335.87 |
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 |
274 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
81031 |
Total Medical Medicare Allowed Amount |
15280.68 |
Total Medical Medicare Payment Amount |
11883.28 |
Total Medical Medicare Standardized Payment Amount |
14335.87 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
52 |
Number Of Male Beneficiaries |
92 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
65 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.4219 |