National Provider Identifier [NPI]: |
1811995558 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 THOMAS MORE PKWY |
Street Address 2 Of The Provider |
STE 280 |
City Of The Provider |
CRESTVIEW HILLS |
Zip Code Of The Provider |
410175465 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
513 |
Number Of Medicare Beneficiaries |
430 |
Total Submitted Charge Amount |
56563 |
Total Medicare Allowed Amount |
30089.88 |
Total Medicare Payment Amount |
18465.8 |
Total Medicare Standardized Payment Amount |
25416.55 |
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 |
5 |
Number Of Medical Services |
513 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
56563 |
Total Medical Medicare Allowed Amount |
30089.88 |
Total Medical Medicare Payment Amount |
18465.8 |
Total Medical Medicare Standardized Payment Amount |
25416.55 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
372 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5264 |