National Provider Identifier [NPI]: |
1245583442 |
Last Name Of The Provider |
GAINER |
First Name Of The Provider |
JUDY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
39350 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTHVILLE TOWNSHIP |
Zip Code Of The Provider |
481679164 |
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 |
15 |
Number Of Services |
249 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
7892.9 |
Total Medicare Allowed Amount |
7626.34 |
Total Medicare Payment Amount |
6921.26 |
Total Medicare Standardized Payment Amount |
7590.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
113 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
3394.9 |
Total Drug Medicare AllowedAmount |
3335.62 |
Total Drug Medicare PaymentAmount |
3267.51 |
Total Drug Medicare Standardized Payment Amount |
3267.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
136 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
4498 |
Total Medical Medicare Allowed Amount |
4290.72 |
Total Medical Medicare Payment Amount |
3653.75 |
Total Medical Medicare Standardized Payment Amount |
4322.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
114 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7718 |