National Provider Identifier [NPI]: |
1760721823 |
Last Name Of The Provider |
DIEGEL |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 CRESSON BLVD |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
PHOENIXVILLE |
Zip Code Of The Provider |
194606127 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
166 |
Number Of Medicare Beneficiaries |
75 |
Total Submitted Charge Amount |
19048.71 |
Total Medicare Allowed Amount |
9374.46 |
Total Medicare Payment Amount |
6339.8 |
Total Medicare Standardized Payment Amount |
7379.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
453.25 |
Total Drug Medicare AllowedAmount |
65.91 |
Total Drug Medicare PaymentAmount |
53.24 |
Total Drug Medicare Standardized Payment Amount |
53.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
136 |
Number Of Medicare Beneficiaries With Medical Services |
75 |
Total Medical Submitted Charge Amount |
18595.46 |
Total Medical Medicare Allowed Amount |
9308.55 |
Total Medical Medicare Payment Amount |
6286.56 |
Total Medical Medicare Standardized Payment Amount |
7326.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
28 |
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 |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9143 |