National Provider Identifier [NPI]: |
1588614333 |
Last Name Of The Provider |
HUSTON-SHAIKH |
First Name Of The Provider |
CORINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 WASHINGTON AVE N |
Street Address 2 Of The Provider |
SUITE 5000 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554011377 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
76 |
Number Of Medicare Beneficiaries |
52 |
Total Submitted Charge Amount |
3891 |
Total Medicare Allowed Amount |
2872.33 |
Total Medicare Payment Amount |
2176.91 |
Total Medicare Standardized Payment Amount |
2557.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
570 |
Total Drug Medicare AllowedAmount |
385.13 |
Total Drug Medicare PaymentAmount |
377.42 |
Total Drug Medicare Standardized Payment Amount |
377.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
54 |
Number Of Medicare Beneficiaries With Medical Services |
51 |
Total Medical Submitted Charge Amount |
3321 |
Total Medical Medicare Allowed Amount |
2487.2 |
Total Medical Medicare Payment Amount |
1799.49 |
Total Medical Medicare Standardized Payment Amount |
2180.1 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
18 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7623 |