National Provider Identifier [NPI]: |
1043367311 |
Last Name Of The Provider |
PAIGE |
First Name Of The Provider |
VIRGINIA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
R.N., M.S.N. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2799 W GRAND BLVD |
Street Address 2 Of The Provider |
DEPARTMENT OF INTERNAL MEDICINE |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022608 |
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 |
7 |
Number Of Services |
67 |
Number Of Medicare Beneficiaries |
47 |
Total Submitted Charge Amount |
20591 |
Total Medicare Allowed Amount |
5914.15 |
Total Medicare Payment Amount |
4636.79 |
Total Medicare Standardized Payment Amount |
5250.95 |
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 |
7 |
Number Of Medical Services |
67 |
Number Of Medicare Beneficiaries With Medical Services |
47 |
Total Medical Submitted Charge Amount |
20591 |
Total Medical Medicare Allowed Amount |
5914.15 |
Total Medical Medicare Payment Amount |
4636.79 |
Total Medical Medicare Standardized Payment Amount |
5250.95 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
14 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
30 |
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 |
17 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
45 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
3.6694 |