National Provider Identifier [NPI]: |
1649512005 |
Last Name Of The Provider |
DUFFY |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12380 PLAZA DR |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PARMA |
Zip Code Of The Provider |
441301043 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
754 |
Number Of Medicare Beneficiaries |
95 |
Total Submitted Charge Amount |
79379 |
Total Medicare Allowed Amount |
49132.02 |
Total Medicare Payment Amount |
36524.94 |
Total Medicare Standardized Payment Amount |
44306.48 |
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 |
5 |
Number Of Medical Services |
754 |
Number Of Medicare Beneficiaries With Medical Services |
95 |
Total Medical Submitted Charge Amount |
79379 |
Total Medical Medicare Allowed Amount |
49132.02 |
Total Medical Medicare Payment Amount |
36524.94 |
Total Medical Medicare Standardized Payment Amount |
44306.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
12 |
Number Of Black or African American Beneficiaries |
83 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
40 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
3.2831 |