Medicare Facts for Monica R. Porrett


National Provider Identifier [NPI]: 1073763777
Last Name Of The Provider PORRETT
First Name Of The Provider MONICA
Middle Initial Of The Provider R
Credentials Of The Provider
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 3111 ELECTRIC AVENUE
Street Address 2 Of The Provider
City Of The Provider PORT HURON
Zip Code Of The Provider 48060
State Code Of The Provider MI
Country Code Of The Provider US
Provider Type Of The Provider Licensed Clinical Social Worker
Medicare Participation Indicator Y
Number Of HCPCS 3
Number Of Services 130
Number Of Medicare Beneficiaries 14
Total Submitted Charge Amount 12637.41
Total Medicare Allowed Amount 5808.71
Total Medicare Payment Amount 4493.8
Total Medicare Standardized Payment Amount 4541.57
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 3
Number Of Medical Services 130
Number Of Medicare Beneficiaries With Medical Services 14
Total Medical Submitted Charge Amount 12637.41
Total Medical Medicare Allowed Amount 5808.71
Total Medical Medicare Payment Amount 4493.8
Total Medical Medicare Standardized Payment Amount 4541.57
Average Age Of Beneficiaries 50
Number Of Beneficiaries Age Less65 14
Number Of Beneficiaries Age 65 to 74 0
Number Of Beneficiaries Age 75 to 84 0
Number Of Beneficiaries Age Greater 84 0
Number Of Female Beneficiaries
Number Of Male Beneficiaries
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 0
Percent Of With Alzheimers Disease or Dementia 0
Percent Of With Asthma
Percent Of With Cancer 0
Percent Of With Heart Failure 0
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 75
Percent Of With Diabetes
Percent Of With Hyperlipidemia
Percent Of With Hypertension
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis 0
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 1.1917

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