National Provider Identifier [NPI]: |
1518959261 |
Last Name Of The Provider |
ROSS |
First Name Of The Provider |
CLARE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
C.R.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
125 SHOREWAY DR |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
QUEENSTOWN |
Zip Code Of The Provider |
216581666 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
1771 |
Number Of Medicare Beneficiaries |
299 |
Total Submitted Charge Amount |
106595 |
Total Medicare Allowed Amount |
55328.34 |
Total Medicare Payment Amount |
40597.02 |
Total Medicare Standardized Payment Amount |
45730.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
109 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
4372 |
Total Drug Medicare AllowedAmount |
3032.86 |
Total Drug Medicare PaymentAmount |
2947.05 |
Total Drug Medicare Standardized Payment Amount |
2947.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
1662 |
Number Of Medicare Beneficiaries With Medical Services |
299 |
Total Medical Submitted Charge Amount |
102223 |
Total Medical Medicare Allowed Amount |
52295.48 |
Total Medical Medicare Payment Amount |
37649.97 |
Total Medical Medicare Standardized Payment Amount |
42783.78 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
217 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
280 |
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 |
258 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9185 |