National Provider Identifier [NPI]: |
1639103153 |
Last Name Of The Provider |
HOOVER |
First Name Of The Provider |
IRENE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 W UNIVERSITY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MUNCIE |
Zip Code Of The Provider |
473033428 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
1176 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
178506 |
Total Medicare Allowed Amount |
95271.61 |
Total Medicare Payment Amount |
74437.52 |
Total Medicare Standardized Payment Amount |
90414.94 |
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 |
8 |
Number Of Medical Services |
1176 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
178506 |
Total Medical Medicare Allowed Amount |
95271.61 |
Total Medical Medicare Payment Amount |
74437.52 |
Total Medical Medicare Standardized Payment Amount |
90414.94 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
36 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
55 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
73 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
70 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.275 |