National Provider Identifier [NPI]: |
1710218276 |
Last Name Of The Provider |
SELTEN |
First Name Of The Provider |
JANINE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7073 CLYO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CENTERVILLE |
Zip Code Of The Provider |
454594816 |
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 |
18 |
Number Of Services |
972 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
101453.64 |
Total Medicare Allowed Amount |
61047.1 |
Total Medicare Payment Amount |
47472.09 |
Total Medicare Standardized Payment Amount |
57782.63 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
247 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
55 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.3975 |