National Provider Identifier [NPI]: |
1093836850 |
Last Name Of The Provider |
LONGPRE |
First Name Of The Provider |
DONNA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1414 N VERCLER RD STE 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992161092 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
423 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
47920 |
Total Medicare Allowed Amount |
23188.47 |
Total Medicare Payment Amount |
16485.32 |
Total Medicare Standardized Payment Amount |
20076.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
855 |
Total Drug Medicare AllowedAmount |
673.5 |
Total Drug Medicare PaymentAmount |
585.5 |
Total Drug Medicare Standardized Payment Amount |
585.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
387 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
47065 |
Total Medical Medicare Allowed Amount |
22514.97 |
Total Medical Medicare Payment Amount |
15899.82 |
Total Medical Medicare Standardized Payment Amount |
19491.06 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
60 |
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 |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8713 |