National Provider Identifier [NPI]: |
1700868486 |
Last Name Of The Provider |
RUNKEL |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
A.R.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 LAUREL ST |
Street Address 2 Of The Provider |
SUITE A250 |
City Of The Provider |
DES MOINES |
Zip Code Of The Provider |
503143017 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1862 |
Number Of Medicare Beneficiaries |
929 |
Total Submitted Charge Amount |
276792 |
Total Medicare Allowed Amount |
118426.29 |
Total Medicare Payment Amount |
87355.09 |
Total Medicare Standardized Payment Amount |
113647.23 |
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 |
1862 |
Number Of Medicare Beneficiaries With Medical Services |
929 |
Total Medical Submitted Charge Amount |
276792 |
Total Medical Medicare Allowed Amount |
118426.29 |
Total Medical Medicare Payment Amount |
87355.09 |
Total Medical Medicare Standardized Payment Amount |
113647.23 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
307 |
Number Of Beneficiaries Age 75 to 84 |
331 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
496 |
Number Of Male Beneficiaries |
433 |
Number Of Non Hispanic White Beneficiaries |
871 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
741 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
188 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7193 |