National Provider Identifier [NPI]: |
1912090507 |
Last Name Of The Provider |
WOEHL |
First Name Of The Provider |
JENNIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
382 N 120TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLAND |
Zip Code Of The Provider |
49424 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
263 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
23583 |
Total Medicare Allowed Amount |
13100.64 |
Total Medicare Payment Amount |
8617.84 |
Total Medicare Standardized Payment Amount |
12038.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
328 |
Total Drug Medicare AllowedAmount |
231.52 |
Total Drug Medicare PaymentAmount |
216.26 |
Total Drug Medicare Standardized Payment Amount |
216.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
233 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
23255 |
Total Medical Medicare Allowed Amount |
12869.12 |
Total Medical Medicare Payment Amount |
8401.58 |
Total Medical Medicare Standardized Payment Amount |
11822.44 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
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 |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9891 |