National Provider Identifier [NPI]: |
1467796821 |
Last Name Of The Provider |
PITTMAN |
First Name Of The Provider |
SHELENA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2050 N HAGGERTY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CANTON |
Zip Code Of The Provider |
481873795 |
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 |
4 |
Number Of Services |
1760 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
309107 |
Total Medicare Allowed Amount |
126959.65 |
Total Medicare Payment Amount |
99513.61 |
Total Medicare Standardized Payment Amount |
113682.37 |
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 |
4 |
Number Of Medical Services |
1760 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
309107 |
Total Medical Medicare Allowed Amount |
126959.65 |
Total Medical Medicare Payment Amount |
99513.61 |
Total Medical Medicare Standardized Payment Amount |
113682.37 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
61 |
Number Of Non Hispanic White Beneficiaries |
126 |
Number Of Black or African American Beneficiaries |
33 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.5092 |