National Provider Identifier [NPI]: |
1629037650 |
Last Name Of The Provider |
HEISE |
First Name Of The Provider |
RHONDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
202 S PARK STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53715 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
551 |
Number Of Medicare Beneficiaries |
237 |
Total Submitted Charge Amount |
120726 |
Total Medicare Allowed Amount |
40442.57 |
Total Medicare Payment Amount |
30081.37 |
Total Medicare Standardized Payment Amount |
36880.69 |
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 |
6 |
Number Of Medical Services |
551 |
Number Of Medicare Beneficiaries With Medical Services |
237 |
Total Medical Submitted Charge Amount |
120726 |
Total Medical Medicare Allowed Amount |
40442.57 |
Total Medical Medicare Payment Amount |
30081.37 |
Total Medical Medicare Standardized Payment Amount |
36880.69 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
223 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.69 |