National Provider Identifier [NPI]: |
1407135569 |
Last Name Of The Provider |
BRICKER |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
185 QUEEN CITY AVE |
Street Address 2 Of The Provider |
WOUND CARE DEPT |
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
031017121 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2207 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
324182 |
Total Medicare Allowed Amount |
105377.49 |
Total Medicare Payment Amount |
79705.34 |
Total Medicare Standardized Payment Amount |
94702.5 |
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 |
33 |
Number Of Medical Services |
2207 |
Number Of Medicare Beneficiaries With Medical Services |
367 |
Total Medical Submitted Charge Amount |
324182 |
Total Medical Medicare Allowed Amount |
105377.49 |
Total Medical Medicare Payment Amount |
79705.34 |
Total Medical Medicare Standardized Payment Amount |
94702.5 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.6709 |