National Provider Identifier [NPI]: |
1215977707 |
Last Name Of The Provider |
WU-GERRARD |
First Name Of The Provider |
YAMILETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MSN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4923 OGLETOWN STANTON RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197132081 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
210 |
Number Of Medicare Beneficiaries |
90 |
Total Submitted Charge Amount |
57807 |
Total Medicare Allowed Amount |
18993.81 |
Total Medicare Payment Amount |
14890.91 |
Total Medicare Standardized Payment Amount |
17177.96 |
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 |
9 |
Number Of Medical Services |
210 |
Number Of Medicare Beneficiaries With Medical Services |
90 |
Total Medical Submitted Charge Amount |
57807 |
Total Medical Medicare Allowed Amount |
18993.81 |
Total Medical Medicare Payment Amount |
14890.91 |
Total Medical Medicare Standardized Payment Amount |
17177.96 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
54 |
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 |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
68 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
8.4479 |