National Provider Identifier [NPI]: |
1932188539 |
Last Name Of The Provider |
BOBAY |
First Name Of The Provider |
CLAUDIA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4665 S STATE ROAD 5 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH WHITLEY |
Zip Code Of The Provider |
467879101 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1477 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
99071 |
Total Medicare Allowed Amount |
36010.48 |
Total Medicare Payment Amount |
21358.72 |
Total Medicare Standardized Payment Amount |
27479.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
747 |
Number Of Medicare Beneficiaries With Drug Services |
89 |
Total Drug Submitted ChargeAmount |
27991 |
Total Drug Medicare AllowedAmount |
4052.41 |
Total Drug Medicare PaymentAmount |
3573.08 |
Total Drug Medicare Standardized Payment Amount |
3573.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
730 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
71080 |
Total Medical Medicare Allowed Amount |
31958.07 |
Total Medical Medicare Payment Amount |
17785.64 |
Total Medical Medicare Standardized Payment Amount |
23906.7 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
97 |
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 |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0443 |