National Provider Identifier [NPI]: |
1295842011 |
Last Name Of The Provider |
TAYLOR |
First Name Of The Provider |
YVONNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APRN, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4303 WOODHALL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482242222 |
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 |
12 |
Number Of Services |
2663 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
378293 |
Total Medicare Allowed Amount |
201313.33 |
Total Medicare Payment Amount |
153980.94 |
Total Medicare Standardized Payment Amount |
177158.72 |
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 |
12 |
Number Of Medical Services |
2663 |
Number Of Medicare Beneficiaries With Medical Services |
521 |
Total Medical Submitted Charge Amount |
378293 |
Total Medical Medicare Allowed Amount |
201313.33 |
Total Medical Medicare Payment Amount |
153980.94 |
Total Medical Medicare Standardized Payment Amount |
177158.72 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
149 |
Number Of Female Beneficiaries |
325 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
434 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
299 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
58 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
29 |
Average HCC Risk Score Of Beneficiaries |
3.5605 |