National Provider Identifier [NPI]: |
1699974956 |
Last Name Of The Provider |
PRETTY |
First Name Of The Provider |
PAULA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
117 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAPAC |
Zip Code Of The Provider |
480143715 |
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 |
59 |
Number Of Services |
592 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
46364 |
Total Medicare Allowed Amount |
26732.74 |
Total Medicare Payment Amount |
19125.61 |
Total Medicare Standardized Payment Amount |
23695.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
2082 |
Total Drug Medicare AllowedAmount |
1233.42 |
Total Drug Medicare PaymentAmount |
1190.87 |
Total Drug Medicare Standardized Payment Amount |
1190.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
522 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
44282 |
Total Medical Medicare Allowed Amount |
25499.32 |
Total Medical Medicare Payment Amount |
17934.74 |
Total Medical Medicare Standardized Payment Amount |
22504.84 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
46 |
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 |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1057 |