National Provider Identifier [NPI]: |
1083829196 |
Last Name Of The Provider |
EUSTICE |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2101 EMRICK BLVD |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
BETHLEHEM |
Zip Code Of The Provider |
180208040 |
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 |
27 |
Number Of Services |
372 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
43530 |
Total Medicare Allowed Amount |
18665.2 |
Total Medicare Payment Amount |
12242.38 |
Total Medicare Standardized Payment Amount |
15764.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
410 |
Total Drug Medicare AllowedAmount |
203.44 |
Total Drug Medicare PaymentAmount |
186.63 |
Total Drug Medicare Standardized Payment Amount |
186.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
352 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
43120 |
Total Medical Medicare Allowed Amount |
18461.76 |
Total Medical Medicare Payment Amount |
12055.75 |
Total Medical Medicare Standardized Payment Amount |
15577.52 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
176 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1316 |