National Provider Identifier [NPI]: |
1891082103 |
Last Name Of The Provider |
DOLAN |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
461221948 |
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 |
12 |
Number Of Services |
350 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
70927 |
Total Medicare Allowed Amount |
34819.84 |
Total Medicare Payment Amount |
27298.22 |
Total Medicare Standardized Payment Amount |
33373.14 |
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 |
12 |
Number Of Medical Services |
350 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
70927 |
Total Medical Medicare Allowed Amount |
34819.84 |
Total Medical Medicare Payment Amount |
27298.22 |
Total Medical Medicare Standardized Payment Amount |
33373.14 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
79 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
51 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.4941 |