National Provider Identifier [NPI]: |
1710094123 |
Last Name Of The Provider |
FREELAND |
First Name Of The Provider |
KATHLEEN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2801 W KINNICKINNIC RIVER PKWY |
Street Address 2 Of The Provider |
SUITE 345 |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532153669 |
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 |
34 |
Number Of Services |
253 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
1973830.2 |
Total Medicare Allowed Amount |
30631.94 |
Total Medicare Payment Amount |
23490.14 |
Total Medicare Standardized Payment Amount |
27729.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
10896 |
Total Drug Medicare AllowedAmount |
4608.45 |
Total Drug Medicare PaymentAmount |
3613.04 |
Total Drug Medicare Standardized Payment Amount |
3613.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
214 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
1962934.2 |
Total Medical Medicare Allowed Amount |
26023.49 |
Total Medical Medicare Payment Amount |
19877.1 |
Total Medical Medicare Standardized Payment Amount |
24116.39 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
91 |
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 |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2194 |