National Provider Identifier [NPI]: |
1356664163 |
Last Name Of The Provider |
D'HUYVETTER |
First Name Of The Provider |
JOLENE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 OAKLEAF WAY |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
ALTOONA |
Zip Code Of The Provider |
547202245 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
279 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
263237.78 |
Total Medicare Allowed Amount |
28312.49 |
Total Medicare Payment Amount |
21918.13 |
Total Medicare Standardized Payment Amount |
27683.86 |
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 |
33 |
Number Of Medical Services |
279 |
Number Of Medicare Beneficiaries With Medical Services |
78 |
Total Medical Submitted Charge Amount |
263237.78 |
Total Medical Medicare Allowed Amount |
28312.49 |
Total Medical Medicare Payment Amount |
21918.13 |
Total Medical Medicare Standardized Payment Amount |
27683.86 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
40 |
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 |
58 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
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 |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8727 |