National Provider Identifier [NPI]: |
1598014953 |
Last Name Of The Provider |
HOWARD |
First Name Of The Provider |
DONNA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4403 HARRISON BLVD |
Street Address 2 Of The Provider |
#3630 |
City Of The Provider |
OGDEN |
Zip Code Of The Provider |
844033271 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
721 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
54636 |
Total Medicare Allowed Amount |
35313 |
Total Medicare Payment Amount |
21992.69 |
Total Medicare Standardized Payment Amount |
27753.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
661 |
Total Drug Medicare AllowedAmount |
549.92 |
Total Drug Medicare PaymentAmount |
529.28 |
Total Drug Medicare Standardized Payment Amount |
529.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
685 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
53975 |
Total Medical Medicare Allowed Amount |
34763.08 |
Total Medical Medicare Payment Amount |
21463.41 |
Total Medical Medicare Standardized Payment Amount |
27224.53 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
215 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3363 |