National Provider Identifier [NPI]: |
1952388506 |
Last Name Of The Provider |
VILLENEUVE |
First Name Of The Provider |
ROSETTA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 GOLF COURSE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
557448648 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
793 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
83521.09 |
Total Medicare Allowed Amount |
48672.09 |
Total Medicare Payment Amount |
33602.56 |
Total Medicare Standardized Payment Amount |
41626.88 |
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 |
20 |
Number Of Medical Services |
793 |
Number Of Medicare Beneficiaries With Medical Services |
297 |
Total Medical Submitted Charge Amount |
83521.09 |
Total Medical Medicare Allowed Amount |
48672.09 |
Total Medical Medicare Payment Amount |
33602.56 |
Total Medical Medicare Standardized Payment Amount |
41626.88 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
283 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6107 |