| National Provider Identifier [NPI]: | 1992766869 |
| Last Name Of The Provider | BARTHOLIC |
| First Name Of The Provider | GAY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | CNS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2345 ARIEL STREET N - MAIL STOP 13601A |
| Street Address 2 Of The Provider | HEALTHPARTNERS REGIONS BEHAVIORAL HEALTH - MAPLEWOOD |
| City Of The Provider | MAPLEWOOD |
| Zip Code Of The Provider | 551092248 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 522 |
| Number Of Medicare Beneficiaries | 155 |
| Total Submitted Charge Amount | 130958 |
| Total Medicare Allowed Amount | 41883.2 |
| Total Medicare Payment Amount | 26457.44 |
| Total Medicare Standardized Payment Amount | 33273.28 |
| 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 | 9 |
| Number Of Medical Services | 522 |
| Number Of Medicare Beneficiaries With Medical Services | 155 |
| Total Medical Submitted Charge Amount | 130958 |
| Total Medical Medicare Allowed Amount | 41883.2 |
| Total Medical Medicare Payment Amount | 26457.44 |
| Total Medical Medicare Standardized Payment Amount | 33273.28 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | 8 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 32 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1332 |