National Provider Identifier [NPI]: |
1205886173 |
Last Name Of The Provider |
MATTES |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 W OKLAHOMA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532154330 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
199 |
Number Of Medicare Beneficiaries |
125 |
Total Submitted Charge Amount |
49735 |
Total Medicare Allowed Amount |
12494.63 |
Total Medicare Payment Amount |
9286.58 |
Total Medicare Standardized Payment Amount |
11628.49 |
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 |
14 |
Number Of Medical Services |
199 |
Number Of Medicare Beneficiaries With Medical Services |
125 |
Total Medical Submitted Charge Amount |
49735 |
Total Medical Medicare Allowed Amount |
12494.63 |
Total Medical Medicare Payment Amount |
9286.58 |
Total Medical Medicare Standardized Payment Amount |
11628.49 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
105 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
69 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4663 |