National Provider Identifier [NPI]: |
1194164319 |
Last Name Of The Provider |
WESTHOFF |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
NP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5050 N CLINTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468255886 |
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 |
19 |
Number Of Services |
556 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
90329 |
Total Medicare Allowed Amount |
60225 |
Total Medicare Payment Amount |
46387.04 |
Total Medicare Standardized Payment Amount |
57627.01 |
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 |
19 |
Number Of Medical Services |
556 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
90329 |
Total Medical Medicare Allowed Amount |
60225 |
Total Medical Medicare Payment Amount |
46387.04 |
Total Medical Medicare Standardized Payment Amount |
57627.01 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
97 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
220 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2885 |