National Provider Identifier [NPI]: |
1831334762 |
Last Name Of The Provider |
PRATT |
First Name Of The Provider |
SANDRA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
RN, MSN, FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1722 SHAFFER ST |
Street Address 2 Of The Provider |
HEART FAILURE CLINIC AT BORGESS, SUITE 3 |
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490481633 |
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 |
8 |
Number Of Services |
375 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
50107 |
Total Medicare Allowed Amount |
25680.58 |
Total Medicare Payment Amount |
19530.55 |
Total Medicare Standardized Payment Amount |
24122.15 |
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 |
8 |
Number Of Medical Services |
375 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
50107 |
Total Medical Medicare Allowed Amount |
25680.58 |
Total Medical Medicare Payment Amount |
19530.55 |
Total Medical Medicare Standardized Payment Amount |
24122.15 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
35 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
83 |
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 |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0175 |