National Provider Identifier [NPI]: |
1043268212 |
Last Name Of The Provider |
ADAMS-HAYES |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7900 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
SUITE 304 |
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044128 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
5020 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
321176.41 |
Total Medicare Allowed Amount |
178421.08 |
Total Medicare Payment Amount |
145048.79 |
Total Medicare Standardized Payment Amount |
154377.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
86 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
5754 |
Total Drug Medicare AllowedAmount |
1750.02 |
Total Drug Medicare PaymentAmount |
1345.11 |
Total Drug Medicare Standardized Payment Amount |
1345.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
4934 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
315422.41 |
Total Medical Medicare Allowed Amount |
176671.06 |
Total Medical Medicare Payment Amount |
143703.68 |
Total Medical Medicare Standardized Payment Amount |
153032.56 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
298 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
336 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
277 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4915 |