National Provider Identifier [NPI]: |
1629082664 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7441 O ST STE 304 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685102466 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
370 |
Number Of Medicare Beneficiaries |
115 |
Total Submitted Charge Amount |
39579.73 |
Total Medicare Allowed Amount |
31430.85 |
Total Medicare Payment Amount |
24245.55 |
Total Medicare Standardized Payment Amount |
30211.58 |
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 |
10 |
Number Of Medical Services |
370 |
Number Of Medicare Beneficiaries With Medical Services |
115 |
Total Medical Submitted Charge Amount |
39579.73 |
Total Medical Medicare Allowed Amount |
31430.85 |
Total Medical Medicare Payment Amount |
24245.55 |
Total Medical Medicare Standardized Payment Amount |
30211.58 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
61 |
Number Of Non Hispanic White Beneficiaries |
95 |
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 |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
66 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
6.4417 |