National Provider Identifier [NPI]: |
1982650750 |
Last Name Of The Provider |
BUDDING |
First Name Of The Provider |
SHIRLEY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CNS, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 PHILADELPHIA DR |
Street Address 2 Of The Provider |
STE 4505 |
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454061813 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
617 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
61809 |
Total Medicare Allowed Amount |
39906.85 |
Total Medicare Payment Amount |
28317.38 |
Total Medicare Standardized Payment Amount |
36145.72 |
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 |
12 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
61809 |
Total Medical Medicare Allowed Amount |
39906.85 |
Total Medical Medicare Payment Amount |
28317.38 |
Total Medical Medicare Standardized Payment Amount |
36145.72 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
127 |
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 |
89 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7684 |