National Provider Identifier [NPI]: |
1396023719 |
Last Name Of The Provider |
BASSETT |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
325 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
9433.53 |
Total Medicare Allowed Amount |
9120.93 |
Total Medicare Payment Amount |
8456.85 |
Total Medicare Standardized Payment Amount |
9351.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
150 |
Number Of Medicare Beneficiaries With Drug Services |
149 |
Total Drug Submitted ChargeAmount |
4336.53 |
Total Drug Medicare AllowedAmount |
4336.53 |
Total Drug Medicare PaymentAmount |
4218.8 |
Total Drug Medicare Standardized Payment Amount |
4218.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
175 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
5097 |
Total Medical Medicare Allowed Amount |
4784.4 |
Total Medical Medicare Payment Amount |
4238.05 |
Total Medical Medicare Standardized Payment Amount |
5132.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
70 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
|
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7099 |