National Provider Identifier [NPI]: |
1699766527 |
Last Name Of The Provider |
MORSE |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2434 W BELVEDERE AVE |
Street Address 2 Of The Provider |
LEVINDALE HEBREW GERIATRIC CENTER |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212155202 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
237 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
22610 |
Total Medicare Allowed Amount |
14478.03 |
Total Medicare Payment Amount |
8959.5 |
Total Medicare Standardized Payment Amount |
10560.56 |
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 |
4 |
Number Of Medical Services |
237 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
22610 |
Total Medical Medicare Allowed Amount |
14478.03 |
Total Medical Medicare Payment Amount |
8959.5 |
Total Medical Medicare Standardized Payment Amount |
10560.56 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
70 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
41 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.4171 |