National Provider Identifier [NPI]: |
1598973018 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
SUZANNE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2473 MCFARLAND RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611076824 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
500 |
Number Of Medicare Beneficiaries |
312 |
Total Submitted Charge Amount |
57229 |
Total Medicare Allowed Amount |
23239.67 |
Total Medicare Payment Amount |
14694.5 |
Total Medicare Standardized Payment Amount |
18991.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
53 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1148 |
Total Drug Medicare AllowedAmount |
166.7 |
Total Drug Medicare PaymentAmount |
99.87 |
Total Drug Medicare Standardized Payment Amount |
99.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
447 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
56081 |
Total Medical Medicare Allowed Amount |
23072.97 |
Total Medical Medicare Payment Amount |
14594.63 |
Total Medical Medicare Standardized Payment Amount |
18892.11 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0523 |