National Provider Identifier [NPI]: |
1487961132 |
Last Name Of The Provider |
HOLUM |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2880 UNIVERSITY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537053644 |
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 |
25 |
Number Of Services |
426 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
71961 |
Total Medicare Allowed Amount |
20348.2 |
Total Medicare Payment Amount |
12806.31 |
Total Medicare Standardized Payment Amount |
16420.99 |
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 |
25 |
Number Of Medical Services |
426 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
71961 |
Total Medical Medicare Allowed Amount |
20348.2 |
Total Medical Medicare Payment Amount |
12806.31 |
Total Medical Medicare Standardized Payment Amount |
16420.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
249 |
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8521 |