National Provider Identifier [NPI]: |
1326086752 |
Last Name Of The Provider |
HURT |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
RN, BC, FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
875 STATE ROUTE 5 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TIPTON |
Zip Code Of The Provider |
650818441 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
868 |
Number Of Medicare Beneficiaries |
280 |
Total Submitted Charge Amount |
63422 |
Total Medicare Allowed Amount |
26915.12 |
Total Medicare Payment Amount |
16053 |
Total Medicare Standardized Payment Amount |
21252.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
61 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
4911 |
Total Drug Medicare AllowedAmount |
3544.77 |
Total Drug Medicare PaymentAmount |
3470.19 |
Total Drug Medicare Standardized Payment Amount |
3470.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
807 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
58511 |
Total Medical Medicare Allowed Amount |
23370.35 |
Total Medical Medicare Payment Amount |
12582.81 |
Total Medical Medicare Standardized Payment Amount |
17782.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
0.9308 |